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NPI Code Detail

MEDICARE: DR. CHRISTINA HERRERA DO

MEDICARE: DR. CHRISTINA HERRERA DO
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
1208000000XPediatrics Physician0116032017VA

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 : 1407340920
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINA HERRERA DO
Provider Business Mailing Address
First Line : 10644 SHEEPSHEAD BAY AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89166-8016
Country : US
Telephone Number : 702-169-0603
Fax Number :
Provider Business Practice Location Address
First Line : 10105 BANBURRY CROSS DR STE 170
Second Line :
City : LAS VEGAS
State : NV
Zip : 89144-6647
Country : US
Telephone Number : 543-770-2765
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2018
Last Update Date : 08/06/2021

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