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Organization
ALTA MEDICAL CLINIC INC OF NEVADA
Active
Organization
ALTA MEDICAL CLINIC INC OF NEVADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLADELYNN ADLAO APRN (VICE PRESIDENT)
(626) 705-1005
Entity
Organization
Contact information
Practice address
1500 E TROPICANA AVE STE 163, LAS VEGAS, NV 89119-6516
(626) 705-1005
Mailing address
1500 E TROPICANA AVE STE 163, LAS VEGAS, NV 89119-6516
(626) 705-1005
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
NULL
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
NULL
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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