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NPI Code Detail

MEDICARE: DR. ROBERTO DE CASTRO CHUAPOCO JR. M.D.

MEDICARE: DR. ROBERTO DE CASTRO CHUAPOCO JR. M.D.
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
1208100000XPhysical Medicine & Rehabilitation Physician11482NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891883922
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERTO DE CASTRO CHUAPOCO JR. M.D.
Provider Business Mailing Address
First Line : 8608 MIRADA DEL SOL DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-8206
Country : US
Telephone Number : 702-968-2425
Fax Number : 702-968-2488
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 : 702-968-2425
Fax Number : 702-968-2488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 03/22/2023

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