Individual
HIMA YALAMANCHILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10624 S EASTERN AVE STE A-955, HENDERSON, NV 89052-2982
(702) 800-5393
(702) 407-7016
Mailing address
10624 S EASTERN AVE STE A-955, HENDERSON, NV 89052-2982
(702) 800-5393
(702) 407-7016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19314
NV
207Q00000X
Family Medicine Physician
MD.207879
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811263601
—
NV
01
—
19314
STATE LICENSE
NV
Enumeration date
03/27/2012
Last updated
03/17/2022
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