Healthcare Provider Details

I. General information

NPI: 1669517116
Provider Name (Legal Business Name): SETSUKO HEDANO SAGE O.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 01/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7381 PRAIRIE FALCON RD STE 141
LAS VEGAS NV
89128-0812
US

IV. Provider business mailing address

7381 PRAIRIE FALCON RD STE 141
LAS VEGAS NV
89128-0812
US

V. Phone/Fax

Practice location:
  • Phone: 702-348-7742
  • Fax:
Mailing address:
  • Phone: 702-348-7742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number880437957
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: