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General NPI Number Information
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NPI Number | 1942688932
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Entity Type | Organization
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Legal Business Name | DOCTORS CENTER AT RED ROCK CAPOBIANCO PLLC
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 2801 N TENAYA WAY STE C
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City | LAS VEGAS
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State | NV
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Zip | 89128-1400
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Country | US
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Telephone | 702-684-7800
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Fax | 702-684-7878
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Provider Business Mailing Address
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Address Line | 2801 N TENAYA WAY STE C
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City | LAS VEGAS
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State | NV
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Zip | 89128-1400
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Country | US
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Telephone | 702-684-7800
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Fax | 702-684-7878
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Authorized Official
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Title or Position | CREDENTIALING
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Name | KELSI SKEE
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Credential |
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Telephone | 575-313-9251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 958
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License Number State | NV
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