MEDICARE: MR. TAFILELE PALEPOI MAUGA JR.

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	247200000X	Other Technician		NV
2	171W00000X	Contractor		NV

General Provider Information

NPI Number	:	1760357610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. TAFILELE PALEPOI MAUGA JR.

Provider Business Mailing Address
First Line	:	3866 CIVIC CENTER DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-7524
Country	:	US
Telephone Number	:	702-971-6450
Fax Number	:	--

Provider Business Practice Location Address
First Line	:	3866 CIVIC CENTER DR
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-7524
Country	:	US
Telephone Number	:	702-971-6450
Fax Number	:	--

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

Provider Enumeration Date	:	10/09/2025
Last Update Date	:	10/09/2025

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