Organization
ALTA MEDICAL CLINIC INC OF NEVADA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLADELYNN ADLAO APRN (VICE PRESIDENT)
(626) 705-1005
Entity
Organization
Contact information
Practice address
1500 E TROPICANA AVE STE 163, LAS VEGAS, NV 89119-6516
(626) 705-1005
Mailing address
1500 E TROPICANA AVE STE 163, LAS VEGAS, NV 89119-6516
(626) 705-1005
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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