Organization
LAS VEGAS CLINIC FOR CHILDREN & YOUTH
Active
Organization
LAS VEGAS CLINIC FOR CHILDREN & YOUTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE P BUNCH MD (PRESIDENT MD)
(505) 425-3566
Entity
Organization
Contact information
Practice address
501 7TH STREET, LAS VEGAS, NM 87701
(505) 425-3566
(505) 425-3568
Mailing address
501 7TH STREET, LAS VEGAS, NM 87701
(505) 425-3566
(505) 425-3568
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49395
—
NM
Enumeration date
12/04/2006
Last updated
08/22/2020
Update your record
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