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General NPI Number Information
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NPI Number | 1821568528
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Entity Type | Individual
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Provider Name | RAMON GONZALES BAYUGA NP
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Gender | Male
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Dates
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Enumeration Date | 11/26/2018
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Last Update Date | 11/26/2018
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Provider Practice Location Address
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Address Line | 6859 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89119-0002
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Country | US
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Telephone | 702-888-1037
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Fax |
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Provider Business Mailing Address
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Address Line | 5567 JELSMA AVE
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City | LAS VEGAS
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State | NV
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Zip | 89141-8683
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Country | US
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Telephone | 909-576-3658
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 812957
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License Number State | NV
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