Healthcare Provider Details

I. General information

NPI: 1760686158
Provider Name (Legal Business Name): ALEXANDER C NOCHE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 N NELLIS BLVD
LAS VEGAS NV
89110-5339
US

IV. Provider business mailing address

7017 S BUFFALO DR #1155
LAS VEGAS NV
89113-4092
US

V. Phone/Fax

Practice location:
  • Phone: 702-438-4003
  • Fax: 702-438-0555
Mailing address:
  • Phone: 213-290-8798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12896
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: