Healthcare Provider Details

I. General information

NPI: 1538054598
Provider Name (Legal Business Name): MR. PATRICK JOSEPH ESPINOSA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 W FLAMINGO RD
LAS VEGAS NV
89103-3705
US

IV. Provider business mailing address

515 FOSTER SPRINGS RD
LAS VEGAS NV
89148-4477
US

V. Phone/Fax

Practice location:
  • Phone: 702-871-9917
  • Fax:
Mailing address:
  • Phone: 323-595-8463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberLPN17741
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: