Individual
JOAQUIM S TAVARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6040 S FORT APACHE RD STE 100, LAS VEGAS, NV 89148-5613
(702) 476-4900
(702) 476-4949
Mailing address
1801 W OLYMPIC BLVD # 1270, PASADENA, CA 91199-0001
(702) 791-1454
(702) 946-1354
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
9087
NV
207RP1001X
Pulmonary Disease Physician
9087
NV
207RS0012X
Sleep Medicine (Internal Medicine) Physician
9087
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XPY196745
MEDI CAL
CA
Enumeration date
10/06/2005
Last updated
08/13/2015
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