Healthcare Provider Details

I. General information

NPI: 1245832013
Provider Name (Legal Business Name): JOSHUA MICHAEL WELTHA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 N TENAYA WAY STE 100
LAS VEGAS NV
89128-1404
US

IV. Provider business mailing address

2901 N TENAYA WAY STE 100
LAS VEGAS NV
89128-1404
US

V. Phone/Fax

Practice location:
  • Phone: 702-870-8852
  • Fax:
Mailing address:
  • Phone: 702-870-8852
  • Fax: 702-870-8914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2593
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: