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NPI Code Detail

MEDICARE: DR. GRACE CANO-DEBELEN MD

MEDICARE: DR. GRACE CANO-DEBELEN 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
1208000000XPediatrics Physician10006NV

General Provider Information

NPI Number : 1679599013
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GRACE CANO-DEBELEN MD
Provider Business Mailing Address
First Line : PO BOX 82277
Second Line :
City : LAS VEGAS
State : NV
Zip : 89180
Country : US
Telephone Number : 702-894-9422
Fax Number : 902-894-9258
Provider Business Practice Location Address
First Line : 4375 S BUFFALO DR
Second Line : STE 101
City : LAS VEGAS
State : NV
Zip : 89147
Country : US
Telephone Number : 702-894-9422
Fax Number : 902-894-9258
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 07/08/2007

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Directions to “ DR. GRACE CANO-DEBELEN MD” Practice Location

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