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General NPI Number Information
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NPI Number | 1093254484
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Entity Type | Organization
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Legal Business Name | CLKR
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 2828 E. LAKE MEAD BLVD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030
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Country | US
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Telephone | 702-551-2222
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Fax | 702-448-4755
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Provider Business Mailing Address
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Address Line | 2828 E. LAKE MEAD BLVD
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030
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Country | US
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Telephone | 702-551-2222
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Fax | 702-448-4755
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Authorized Official
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Title or Position | OWNER
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Name | MR. OSCAR TORO
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Credential |
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Telephone | 702-583-0848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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