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NPI Code Detail

MEDICARE: MICHAEL J MANGIARACINA PA-C

MEDICARE: MICHAEL J MANGIARACINA PA-C
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
1363A00000XPhysician AssistantPA892NV

Other Identifiers

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

General Provider Information

NPI Number : 1386744126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL J MANGIARACINA PA-C
Provider Business Mailing Address
First Line : 9550 S EASTERN AVE STE 253
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-8042
Country : US
Telephone Number : 888-803-3370
Fax Number : 888-803-3331
Provider Business Practice Location Address
First Line : 9550 S EASTERN AVE STE 253
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-8042
Country : US
Telephone Number : 888-803-3370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 11/13/2024

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Directions to “ MICHAEL J MANGIARACINA PA-C” Practice Location

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