| San Carlos Medical | |
|
2400 W Charleston Blvd Las Vegas NV 89102-2179 | |
| (702) 320-7930 | |
| (702) 320-7932 |
| Full Name | San Carlos Medical |
|---|---|
| Speciality | Family Medicine |
| Location | 2400 W Charleston Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Carlos R. Anaya (PRESIDENT) |
| Authorized Official Contact | 7023207930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Carlos Medical 2400 W Charleston Blvd Las Vegas NV 89102-2179 Ph: (702) 320-7930 | San Carlos Medical 2400 W Charleston Blvd Las Vegas NV 89102-2179 Ph: (702) 320-7930 |
| NPI Number | 1174600845 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 04/25/2013 |
| Medicare PECOS PAC ID | 8224176904 |
|---|---|
| Medicare Enrollment ID | O20091118000123 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174600845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9391 (Nevada) | Primary |
| Provider Name | Carlos R Anaya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457431439 PECOS PAC ID: 2961540646 Enrollment ID: I20091118000117 |
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