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Individual

DR. JOSELO ATIENZA VICUNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2365 REYNOLDS AVE, 211, NORTH LAS VEGAS, NV 89030-7276
(702) 399-1287
(702) 649-8064
Mailing address
PO BOX 98978, LAS VEGAS, NV 89193-8978
(702) 507-2486
(702) 671-6883

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
3370
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1033201082
NV
Enumeration date
09/28/2006
Last updated
01/25/2012
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