Organization
CLINICA MEDICA DEL CANYON GATE
Active
Other names
canyon gate medical group
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA COLON (CREDENTIALING COORDINATOR)
(954) 656-8855
Entity
Organization
Contact information
Practice address
2832 E LAKE MEAD BLVD, SUITE# E, NORTH LAS VEGAS, NV 89030-6550
(702) 649-5155
Mailing address
2929 N UNIVERSITY DR, SUITE# 110, CORAL SPRINGS, FL 33065-5081
(954) 656-8855
(954) 656-8856
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12464
NV
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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