Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 4926 | NV |
NPI | 1083669568 |
---|---|
Provider Name | Rafael A Zenteno |
First Address | Las Vegas, NV 89139-5958 |
Second Address | Las Vegas, NV 89139-5958 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 31/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H37412 | (02) | NV |