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General NPI Number Information
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NPI Number | 1982347662
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Entity Type | Individual
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Provider Name | LUCAS FENGMING GUO PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2022
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 3041 W HORIZON RIDGE PKWY STE 100
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City | HENDERSON
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State | NV
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Zip | 89052-4444
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Country | US
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Telephone | 702-778-8880
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Fax |
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Provider Business Mailing Address
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Address Line | 7963 CARMEL HEIGHTS AVE
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City | LAS VEGAS
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State | NV
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Zip | 89178-3809
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Country | US
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Telephone | 702-477-5093
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21976
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License Number State | NV
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