Organization
INCERA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HORACE GUERRA IV MD (OWNER)
(702) 809-1171
Entity
Organization
Contact information
Practice address
10885 S EASTERN AVE, #100, HENDERSON, NV 89052-5857
(702) 419-9977
(702) 921-0222
Mailing address
4030 S JONES BLVD, #32169, LAS VEGAS, NV 89173-8801
(702) 624-5441
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11608
NV
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
11608
NV
208M00000X
Hospitalist Physician
11608
NV
208M00000X
Hospitalist Physician
6826335-1205
UT
363LG0600X
Gerontology Nurse Practitioner
APRN001889
NV
Other
Enumeration date
12/09/2016
Last updated
11/17/2017
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