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NPI Code Detail

MEDICARE: MR. LOUIS RUBEN NAUNGAYAN IDMT

MEDICARE:  MR. LOUIS RUBEN NAUNGAYAN  IDMT
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
11710I1003XIndependent Duty Medical Technicians

General Provider Information

NPI Number : 1447480801
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LOUIS RUBEN NAUNGAYAN IDMT
Provider Business Mailing Address
First Line : 2918 PARADISE HILL CT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031
Country : US
Telephone Number : 702-556-6558
Fax Number :
Provider Business Practice Location Address
First Line : 2918 PARADISE HILL CT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-0539
Country : US
Telephone Number : 702-556-6558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2009
Last Update Date : 06/10/2011

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Directions to “ MR. LOUIS RUBEN NAUNGAYAN IDMT” Practice Location

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