# JOSELO VICUNA MD LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235324369
- **Authorized official:** JOSELO A VICUNA MD (MEMBER)
- **Authorized official phone:** (702) 921-6829

## Contact information

- **Practice address:** 2031 MCDANIEL ST, SUITE 130, NORTH LAS VEGAS, NV 89030-6303
- **Practice address phone:** (702) 649-3135
- **Mailing address:** 2031 MCDANIEL ST, SUITE 130, NORTH LAS VEGAS, NV 89030-6303
- **Mailing address phone:** (702) 649-3135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 3370 | NV | Yes |

## Other

- **Enumeration date:** 09/11/2007
- **Last updated:** 12/07/2007