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NPI Code Detail

MEDICARE: TINA M BAIZA

MEDICARE: TINA M BAIZA
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1750665170
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA M BAIZA
Provider Business Mailing Address
First Line : 5865 PALMILLA ST UNIT 7
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-4131
Country : US
Telephone Number : 510-725-7162
Fax Number :
Provider Business Practice Location Address
First Line : 2801 S VALLEY VIEW BLVD STE 6
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-0166
Country : US
Telephone Number : 702-922-7015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2011
Last Update Date : 08/30/2017

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Directions to “ TINA M BAIZA ” Practice Location

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