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Contact Information

LAS VEGAS CLINIC FOR CHILDREN & YOUTH
501 7TH STREET
LAS VEGAS, NM87701
 Phone: 505-425-3566
 Fax: 505-425-3568
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for LAS VEGAS CLINIC FOR CHILDREN YOUTH · (Female)

NPI # 1558429720
Status Active
Credentials
Entity Individual
Enumeration date 12/04/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • NM Medicaid 49395
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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