=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871575332
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SALVATORE M GUARNERA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2005
-----------------------------------------------------
Last Update Date | 06/30/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3150 N TENAYA WAY SUITE 555
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89128-0443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-255-5903
-----------------------------------------------------
Fax | 702-255-0001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 43813
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89116-1813
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-460-2304
-----------------------------------------------------
Fax | 702-475-5926
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RP1001X
-----------------------------------------------------
Taxonomy Name | Pulmonary Disease Physician
-----------------------------------------------------
License Number | 6771
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------