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NPI Code Detail

MEDICARE: COMMUNITY HOUSE CALLS OF NEVADA

MEDICARE: COMMUNITY HOUSE CALLS OF NEVADA
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
1363A00000XPhysician Assistant529NV

General Provider Information

NPI Number : 1689119612
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HOUSE CALLS OF NEVADA
Provider Business Mailing Address
First Line : 3211 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1953
Country : US
Telephone Number : 702-525-3436
Fax Number : 702-549-5240
Provider Business Practice Location Address
First Line : 3211 W CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1953
Country : US
Telephone Number : 702-525-3436
Fax Number : 702-549-5240
Authorized Official
Title or Position : P.A. / OWNER
Name : ALFREDO HIBBERT
Credential : P.A.
Telephone Number : 702-525-3436
Provider Enumeration Date : 12/29/2016
Last Update Date : 12/29/2016

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Directions to “COMMUNITY HOUSE CALLS OF NEVADA ” 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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