Organization
EASTERN PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE WIJANGCO NP (NURSE PRACTITIONER/OWNER)
(702) 830-0615
Entity
Organization
Contact information
Practice address
6859 S EASTERN AVE STE 103, LAS VEGAS, NV 89119-0003
(702) 830-0615
Mailing address
6859 S EASTERN AVE STE 103, LAS VEGAS, NV 89119-0003
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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