Organization
NORTH VISTA PHYSICIANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENZO VARIALE (AUTHORIZED OFFICIAL)
(702) 649-7711
Entity
Organization
Contact information
Practice address
1815 E LAKE MEAD BLVD, SUITE 100, NORTH LAS VEGAS, NV 89030-7187
(702) 657-1506
(702) 657-1583
Mailing address
1409 E LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89030-7120
(702) 649-7711
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
NV 13268
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912277641
—
NV
Enumeration date
01/11/2012
Last updated
03/17/2016
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