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Individual

TRISTAN VIZCONDE CHEESMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4029 DEAN MARTIN DR, LAS VEGAS, NV 89103-4138
(702) 848-2256
Mailing address
3210 VALLEY VIEW CT, MORGAN HILL, CA 95037-6628
(408) 228-7061

Taxonomy

Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
363A00000X
Physician Assistant
Primary
PA2176
NV
363AM0700X
Medical Physician Assistant
PA2176
NV

Other

Enumeration date
08/20/2019
Last updated
05/14/2024
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