Healthcare Provider Details

I. General information

NPI: 1356131247
Provider Name (Legal Business Name): CONCEPCION MEDICAL CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 S EASTERN AVE STE 300
LAS VEGAS NV
89169-3345
US

IV. Provider business mailing address

3650 S EASTERN AVE STE 300
LAS VEGAS NV
89169-3345
US

V. Phone/Fax

Practice location:
  • Phone: 702-913-2759
  • Fax:
Mailing address:
  • Phone: 702-333-1009
  • Fax: 702-342-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. GELVIS CONCEPCION
Title or Position: OWNER
Credential: NP
Phone: 702-333-1009