MEDICARE: CLINICA MEDICA VARGAS & ALMONTE

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	261Q00000X	Clinic/Center	12464	NV

General Provider Information

NPI Number	:	1891126157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA MEDICA VARGAS & ALMONTE

Provider Business Mailing Address
First Line	:	2832 E LAKE MEAD BLVD STE E
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6550
Country	:	US
Telephone Number	:	702-476-9600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2832 E LAKE MEAD BLVD STE E
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-6550
Country	:	US
Telephone Number	:	702-476-9600
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MIGUEL A VARGAS LAGUNAS
Credential	:	M.D.
Telephone Number	:	702-476-9600

Provider Enumeration Date	:	12/11/2013
Last Update Date	:	12/11/2013

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