Healthcare Provider Details

I. General information

NPI: 1750220638
Provider Name (Legal Business Name): ESTEPHANIE ALEXANDRA PADILLA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 PINTO LN
LAS VEGAS NV
89106-4017
US

IV. Provider business mailing address

PO BOX 450709
WESTLAKE OH
44145-0614
US

V. Phone/Fax

Practice location:
  • Phone: 702-438-2229
  • Fax: 702-605-5031
Mailing address:
  • Phone: 702-330-3102
  • Fax: 702-912-4994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA3458
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: