MEDICARE: HEATHER TADAYON DO

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	208M00000X	Hospitalist Physician	DO1550	NV
2	207R00000X	Internal Medicine Physician	DO1550	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	:	1780854398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER TADAYON DO

Provider Business Mailing Address
First Line	:	7391 W CHARLESTON BLVD
Second Line	:	SUITE 140
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1577
Country	:	US
Telephone Number	:	702-304-2144
Fax Number	:	702-304-2147

Provider Business Practice Location Address
First Line	:	2720 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0424
Country	:	US
Telephone Number	:	702-954-7678
Fax Number	:

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

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	11/18/2025

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Directions to “ HEATHER TADAYON DO” Practice Location

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