Organization
SANTIBANEZ PAC NEVADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ROSER (VP OF BUSINESS OPERATIONS)
(775) 222-0045
Entity
Organization
Contact information
Practice address
3050 N ORMSBY BLVD, CARSON CITY, NV 89703-8378
(775) 883-3622
Mailing address
400 E RIVULON BLVD STE 103, GILBERT, AZ 85297-0096
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/24/2023
Last updated
05/23/2025
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