MEDICARE: MARIA CORAZON OROZCO REGALADO MD

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	174400000X	Specialist	8966	NV
2	207R00000X	Internal Medicine Physician	8966	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	:	1669420402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA CORAZON OROZCO REGALADO MD

Provider Business Mailing Address
First Line	:	1811 S RAINBOW BLVD STE 108
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-0037
Country	:	US
Telephone Number	:	702-876-0350
Fax Number	:	702-847-7437

Provider Business Practice Location Address
First Line	:	1811 S RAINBOW BLVD STE 108
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146
Country	:	US
Telephone Number	:	702-876-0350
Fax Number	:	702-847-7437

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	11/05/2019

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