Individual
MICHAEL J MANGIARACINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9550 S EASTERN AVE STE 253, LAS VEGAS, NV 89123-8042
(888) 803-3370
Mailing address
9550 S EASTERN AVE STE 253, LAS VEGAS, NV 89123-8042
(888) 803-3370
(888) 803-3331
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA892
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505588
—
NV
Enumeration date
09/22/2006
Last updated
11/13/2024
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