MEDICARE: DR. CHRISTINE MARIE ESTRADA DO, MPH

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	207Q00000X	Family Medicine Physician	DO1969	NV
2	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	DO1969	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316126758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE MARIE ESTRADA DO, MPH

Provider Business Mailing Address
First Line	:	3043 PASEO MOUNTAIN AVE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3039
Country	:	US
Telephone Number	:	702-803-0466
Fax Number	:

Provider Business Practice Location Address
First Line	:	6330 S JONES BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-3302
Country	:	US
Telephone Number	:	702-659-9090
Fax Number	:	866-879-7229

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

Provider Enumeration Date	:	11/02/2007
Last Update Date	:	04/20/2020

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