Individual
DR. JOSE ROSAS BACALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6850 N DURANGO DR, SUITE 208, LAS VEGAS, NV 89149-4595
(702) 952-0999
(702) 952-0998
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16237
NV
207Q00000X
Family Medicine Physician
4301101427
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023372612
—
NV
Enumeration date
06/27/2012
Last updated
06/23/2016
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