Individual
JESUS ANGEL CORN SOTELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1422
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285973289
—
NV
01
—
PA1422
STATE LICENSE
NV
Enumeration date
02/11/2013
Last updated
11/15/2022
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