Individual
LAURINE TIBALDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2350 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2149
(702) 797-2163
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 797-2163
(702) 560-2928
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11660
NV
208M00000X
Hospitalist Physician
11660
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100507801
—
NV
05
—
1427024736
—
NV
Enumeration date
02/27/2006
Last updated
02/14/2014
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