Organization
ARK MEDICAL OF LAS VEGAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIO P GONZALES JR. (PRESIDENT/OWNER)
(619) 259-7118
Entity
Organization
Contact information
Practice address
2820 W CHARLESTON BLVD STE D40, LAS VEGAS, NV 89102-1942
(725) 205-0288
(725) 204-9792
Mailing address
7521 SLIPPER ORCHID ST, LAS VEGAS, NV 89148-2616
(619) 259-7118
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
10/10/2023
Last updated
01/14/2024
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