1417088709 NPI number — JOSEPH C NACION MD LTD

Table of content: (NPI 1417088709)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417088709 NPI number — JOSEPH C NACION MD LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOSEPH C NACION MD LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ACI PEDIATRICS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417088709
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2545 S BRUCE ST
Provider Second Line Business Mailing Address:
SUITE 8-10
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89169-1718
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-733-0744
Provider Business Mailing Address Fax Number:
702-796-8262

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2545 S BRUCE ST
Provider Second Line Business Practice Location Address:
SUITE 8-10
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89169-1718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-733-0744
Provider Business Practice Location Address Fax Number:
702-796-8262
Provider Enumeration Date:
03/08/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NACION
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
702-733-0744

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)