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General NPI Number Information
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NPI Number | 1144110693
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Entity Type | Organization
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Legal Business Name | DUAL PATH HEALTH GROUP LLC
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 5440 W SAHARA AVE STE 202C
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City | LAS VEGAS
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State | NV
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Zip | 89146-0361
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Country | US
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Telephone | 702-885-6468
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Fax |
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Provider Business Mailing Address
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Address Line | 5440 W SAHARA AVE STE 202C
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City | LAS VEGAS
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State | NV
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Zip | 89146-0361
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Country | US
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Telephone | 702-885-6468
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Fax |
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Authorized Official
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Title or Position | AUTHORIZE OFFICIAL
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Name | DALMIS DIAZCHALA
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Credential |
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Telephone | 702-885-6468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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