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General NPI Number Information
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NPI Number | 1689402448
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Entity Type | Organization
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Legal Business Name | SAN ALBERTO HEALTH CENTER LLC
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 2820 W CHARLESTON BLVD STE 29
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City | LAS VEGAS
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State | NV
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Zip | 89102-1933
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Country | US
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Telephone | 702-373-3529
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 W CHARLESTON BLVD STE 29
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City | LAS VEGAS
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State | NV
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Zip | 89102-1933
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANOY CAPOTE-DIAZ
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Credential |
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Telephone | 702-373-3529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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