Individual
DENNIS FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
330 S CASINO CENTER BLVD, LAS VEGAS, NV 89101-6102
(702) 671-5638
Mailing address
6288 HUMUS AVE, LAS VEGAS, NV 89139-5457
(702) 639-7699
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2469
NV
363AM0700X
Medical Physician Assistant
PA60732
CA
Other
Enumeration date
10/28/2021
Last updated
05/24/2024
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