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NPI Code Detail

MEDICARE: VALLEY PEDIATRIC & SPECIALTY CENTER

MEDICARE: VALLEY PEDIATRIC & SPECIALTY CENTER
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
1174400000XSpecialist9127NV

General Provider Information

NPI Number : 1568892545
Entity Type Code : Organization
Provider Name (Legal Business Name) : VALLEY PEDIATRIC & SPECIALTY CENTER
Provider Business Mailing Address
First Line : 3100 W CHARLESTON BLVD
Second Line : SUITE 210
City : LAS VEGAS
State : NV
Zip : 89102-2023
Country : US
Telephone Number : 702-388-4428
Fax Number : 702-388-4312
Provider Business Practice Location Address
First Line : 3100 W CHARLESTON BLVD
Second Line : SUITE 210
City : LAS VEGAS
State : NV
Zip : 89102-2023
Country : US
Telephone Number : 702-388-4428
Fax Number : 702-388-4312
Authorized Official
Title or Position : PROVIDER
Name : TERESITA LU MELOCOTON
Credential : MD
Telephone Number : 702-388-4428
Provider Enumeration Date : 11/12/2013
Last Update Date : 11/13/2013

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Directions to “VALLEY PEDIATRIC & SPECIALTY CENTER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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