Healthcare Provider Details

I. General information

NPI: 1740681824
Provider Name (Legal Business Name): INTERNATIONAL NEUROSCIENCE CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 09/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 S 6TH ST
LAS VEGAS NV
89101-6922
US

IV. Provider business mailing address

716 S 6TH ST
LAS VEGAS NV
89101-6922
US

V. Phone/Fax

Practice location:
  • Phone: 702-382-1960
  • Fax:
Mailing address:
  • Phone: 702-382-1960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number4594
License Number StateNV

VIII. Authorized Official

Name: DR. ALBERT CAPANNA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 702-382-1960