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NPI Code Detail

MEDICARE: DR. DALE ALPHONSO ATENCIO PHARMD

MEDICARE:  DR. DALE ALPHONSO ATENCIO  PHARMD
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
1183500000XPharmacist16051NV
2183500000XPharmacistRP00007008NM

General Provider Information

NPI Number : 1497061733
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DALE ALPHONSO ATENCIO PHARMD
Provider Business Mailing Address
First Line : 3717 LAS VEGAS BLVD S
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-4384
Country : US
Telephone Number : 702-262-0635
Fax Number : 702-262-0896
Provider Business Practice Location Address
First Line : 3717 LAS VEGAS BLVD S
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-4384
Country : US
Telephone Number : 702-262-0635
Fax Number : 702-262-0896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2010
Last Update Date : 11/23/2012

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Directions to “ DR. DALE ALPHONSO ATENCIO PHARMD” Practice Location

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