Individual
CHARALEE K BASALDUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
540 N NELLIS BLVD, LAS VEGAS, NV 89110-5368
(702) 877-5199
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 877-5199
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13948
NV
207Q00000X
Family Medicine Physician
M-13523
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609036086
—
NV
Enumeration date
06/10/2008
Last updated
01/06/2020
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