Individual
PIO CLAVECILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4475 S EASTERN AVENUE, INTERNAL MEDICINE, HENDERSON, NV 89052-4153
(702) 737-1880
(702) 650-2458
Mailing address
PO BOX 15645, 4475 S EASTERN AVENUE, LAS VEGAS, NV 89114-5645
(702) 737-1880
(702) 650-2458
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12081
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100510968
—
NV
01
—
P00901960
RAILROAD PTAN MEDICARE
NV
Enumeration date
03/09/2006
Last updated
01/17/2017
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