MEDICARE: DR. JOSE MARIA PARTIDA CORONA M.D.

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	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	11639	NV
2	207R00000X	Internal Medicine Physician	11639	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1477518801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE MARIA PARTIDA CORONA M.D.

Provider Business Mailing Address
First Line	:	2950 E FLAMINGO RD
Second Line	:	SUITE E
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5208
Country	:	US
Telephone Number	:	702-565-6004
Fax Number	:	702-566-6009

Provider Business Practice Location Address
First Line	:	2950 E FLAMINGO RD
Second Line	:	SUITE E
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5208
Country	:	US
Telephone Number	:	702-565-6004
Fax Number	:	702-566-6009

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	04/21/2023

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