Individual
MR. TEODORO RIO MONTEMAYOR MANALANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
400 SHADOW LN STE 106, LAS VEGAS, NV 89106-4355
(702) 731-0909
(028) 264-7677
Mailing address
400 SHADOW LN STE 106, LAS VEGAS, NV 89106-4355
(702) 731-0909
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
22779
CA
363LF0000X
Family Nurse Practitioner
Primary
APRN001535
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902146657
—
NV
Enumeration date
02/18/2013
Last updated
12/19/2018
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