MEDICARE: OSCAR GOMEZ

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	225C00000X	Rehabilitation Counselor	225C00000X	NV

General Provider Information

NPI Number	:	1083032775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OSCAR GOMEZ

Provider Business Mailing Address
First Line	:	2743 S MILLER LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2602
Country	:	US
Telephone Number	:	928-486-5035
Fax Number	:

Provider Business Practice Location Address
First Line	:	2743 S MILLER LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2602
Country	:	US
Telephone Number	:	928-486-5035
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2014
Last Update Date	:	03/31/2014

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Directions to “ OSCAR GOMEZ ” Practice Location

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