Organization
PHYSICAL MEDICINE AND PAIN MANAGEMENT SPECIALIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUEL GALANG ACOSTA M.D. (PRESIDENT)
(702) 248-6850
Entity
Organization
Contact information
Practice address
2770 S MARYLAND PKWY STE 215, LAS VEGAS, NV 89109-1565
(702) 248-6850
(702) 685-7242
Mailing address
2770 S MARYLAND PKWY STE 215, LAS VEGAS, NV 89109-1565
(702) 248-6850
(702) 685-7242
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
10462
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10462
MEDICAL LICENSE
NV
Enumeration date
01/22/2007
Last updated
08/24/2011
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