Individual
JUANCHICHOS T VENTURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1ST AND A ST, HAWTHORNE, NV 89415-1510
(775) 945-2461
(775) 945-2359
Mailing address
PO BOX 1510, HAWTHORNE, NV 89415-1510
(775) 945-2461
(775) 945-2359
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12049
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12049
NEVADA LICENSE
NV
Enumeration date
12/15/2006
Last updated
03/17/2008
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