| NPI | 1770772329 |
|---|---|
| Doing Business As | SAN MARTIN DE PORRES MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | JOSE F TORREBLANCA President 702-734-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2008-04-21 |