Organization
ST CLARE MEDICAL SERVICES INC
Active
Other names
Victor A Deleon, MD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY PHAN (BILLING COORDINATOR)
(702) 808-4741
Entity
Organization
Contact information
Practice address
2525 W CHARLESTON BLVD, SUITE 100, LAS VEGAS, NV 89102-2127
(702) 878-2801
(702) 878-3050
Mailing address
7582 LAS VEGAS BLVD S, SUITE 489, LAS VEGAS, NV 89123-1009
(702) 878-2801
(702) 878-3050
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
NV9215
NV
305R00000X
Preferred Provider Organization
Primary
NV9215
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002018374
—
NV
Enumeration date
09/30/2010
Last updated
10/11/2010
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