MEDICARE: CBAS CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2892	NV
2	225100000X	Physical Therapist	0922	NV
3	225X00000X	Occupational Therapist	10-0052	NV

General Provider Information

NPI Number	:	1023421559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CBAS CONSULTING LLC

Provider Business Mailing Address
First Line	:	7260 W AZURE DR STE 1154
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-7999
Country	:	US
Telephone Number	:	702-462-9571
Fax Number	:	702-988-8819

Provider Business Practice Location Address
First Line	:	5897 NOBLE STAND ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-3895
Country	:	US
Telephone Number	:	702-462-9571
Fax Number	:	702-988-8819

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	DR. ALEJANDRO BECERRA
Credential	:	PHARMD
Telephone Number	:	702-462-9571

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	03/27/2017

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Directions to “CBAS CONSULTING LLC ” Practice Location

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