MEDICARE: ANDREA BEATRIZ BEJARAN CHOTO

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	225100000X	Physical Therapist	7025	NV

General Provider Information

NPI Number	:	1457050528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA BEATRIZ BEJARAN CHOTO

Provider Business Mailing Address
First Line	:	4855 BLUE DIAMOND RD STE 210
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-7602
Country	:	US
Telephone Number	:	725-207-3770
Fax Number	:	702-505-9020

Provider Business Practice Location Address
First Line	:	4855 BLUE DIAMOND RD STE 210
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89139-7602
Country	:	US
Telephone Number	:	725-207-3770
Fax Number	:	702-505-9020

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

Provider Enumeration Date	:	02/28/2023
Last Update Date	:	06/23/2026

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