Organization
MOUNTAIN VISTA PEDIATRICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMUND FARO M.D. (PRESIDENT/OWNER)
(702) 614-5437
Entity
Organization
Contact information
Practice address
6301 MOUNTAIN VISTA ST, SUITE 205, HENDERSON, NV 89014-2364
(702) 614-5437
(702) 990-9927
Mailing address
6301 MOUNTAIN VISTA ST, SUITE 205, HENDERSON, NV 89014-2364
(702) 614-5437
(702) 990-9927
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NV9068
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018597
—
NV
Enumeration date
09/25/2013
Last updated
09/25/2013
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