Individual
ALEJANDRO RACIEL PENA PUPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3468 E SAHARA AVE STE 165, LAS VEGAS, NV 89104-4827
(702) 207-0842
Mailing address
3468 E SAHARA AVE STE 165, LAS VEGAS, NV 89104-4827
(702) 207-0842
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
09/02/2020
Last updated
01/31/2023
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