Healthcare Provider Details

I. General information

NPI: 1336065390
Provider Name (Legal Business Name): MICHAEL LYNDON BATO CANLAPAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4616 W SAHARA AVE STE 337
LAS VEGAS NV
89102-3654
US

IV. Provider business mailing address

956 E SUNSET RD
HENDERSON NV
89011-5476
US

V. Phone/Fax

Practice location:
  • Phone: 702-880-4193
  • Fax: 702-880-4197
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number901709
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: