| NPI | 1649227265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY CASTILLO Associate Director Credentialing, O 702-480-2250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2025-06-27 |