Healthcare Provider Details

I. General information

NPI: 1669993408
Provider Name (Legal Business Name): DAVID JOSEPH COLANGIONE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2017
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 LA CANADA ST
LAS VEGAS NV
89169-2578
US

IV. Provider business mailing address

3131 LA CANADA ST
LAS VEGAS NV
89169-2578
US

V. Phone/Fax

Practice location:
  • Phone: 702-369-7152
  • Fax: 702-369-7153
Mailing address:
  • Phone: 702-369-7152
  • Fax: 702-369-7153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberLL51204
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number51204
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: