Organization
PACIFICA HEALTHCARE PROVIDERS LLC
Active
Other names
CiTi MD
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDIA AVILA (COO)
(702) 826-8889
Entity
Organization
Contact information
Practice address
2755 E DESERT INN RD STE 180, LAS VEGAS, NV 89121-3694
(702) 826-8889
Mailing address
2755 E DESERT INN RD STE 180, LAS VEGAS, NV 89121-3694
(702) 826-8889
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250002866
—
NV
Enumeration date
06/20/2019
Last updated
04/22/2022
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