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NPI Code Detail

MEDICARE: ASHLEY MAESTAS DO

MEDICARE: ASHLEY MAESTAS 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1437617305
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY MAESTAS DO
Provider Business Mailing Address
First Line : 200 MULLINS DR
Second Line :
City : LEBANON
State : OR
Zip : 97355-3983
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 745 W MOANA LN STE 300
Second Line :
City : RENO
State : NV
Zip : 89509-4980
Country : US
Telephone Number : 702-592-3033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2019
Last Update Date : 07/01/2021

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Directions to “ ASHLEY MAESTAS DO” Practice Location

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