GUADALUPE R DOMINGUEZ (NPI# 1649268913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649268913 |
| Entity Type | Individual |
| Full Name | GUADALUPE R DOMINGUEZ |
| Credential | PAC |
| Practice Address |
1905 Civic Center Dr North Las Vegas NV 89030-7143 |
| Mailing Address |
5701 W Charleston Blvd Suite 100 Las Vegas NV 89146-1217 |
| Practice Telephone | 7028779514 |
| Practice Fax Number | 7023123510 |
| Mailing Telephone | 7028779514 |
| Mailing Fax Number | 7023123510 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2020-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA849 | NV | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICAID 31 | 100505577 | 01 | |
| NV | 100505575 | 05 | |
| NV | 1649268913 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679040489 | Guadalupe Dominguez | Case Manager/Care Coordinator | 344 E 100 S, Salt Lake City, UT 84111-1700 | 2018-10-30 |
| 1518290022 | Guadalupe Dominguez | Clinical Nurse Specialist | 4800 Alberta Ave, El Paso, TX 79905-2709 | 2009-09-15 |
| Street Address |
1905 CIVIC CENTER DR |
| City | NORTH LAS VEGAS |
| State | NV |
| Zip Code | 89030-7143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245234145 | Las Vegas Kidney Clinic Inc. | Clinic/Center | 1905 Civic Center Dr, Ste 201, North Las Vegas, NV 89030-7116 | 2005-06-08 |
| 1205184801 | Bio-medical Applications of Nevada, Inc. | Clinic/Center | 1905 Civic Center Dr, Suite 201, North Las Vegas, NV 89030-7143 | 2012-08-29 |
| 1114201704 | Suraj Pratap | Pediatrics | 1905 Civic Center Dr, North Las Vegas, NV 89030-7143 | 2011-10-01 |
| 1003144858 | Sandra Lipovaca | Pediatrics | 1905 Civic Center Dr, North Las Vegas, NV 89030-7143 | 2009-12-04 |
| 1669461455 | Ammar Wehbeh | Obstetrics & Gynecology | 1905 Civic Center Dr, North Las Vegas, NV 89030-7116 | 2005-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043819063 | Ma Guadalupe Ramos Michel | Technician | 2415 Reynolds Ave #101, Las Vegas, NV 89030 | 2020-10-21 |
| 1558968214 | Arturo Juarez Magana | Technician | 2415 Reynolds Ave Suite 101, Las Vegas, NV 89030 | 2020-10-06 |
| 1669088407 | Olivia Lizbeth Santillan-trinidad | Technician | 2415 Reynolds Ave. Ste #101, Las Vegas, NV 89030 | 2020-09-17 |
| 1508471640 | Fabian Aaron Alvarado-perales | Technician | 2415 Reynolds Ave Ste. 101, Las Vegas, NV 89030 | 2020-09-15 |
| 1063047934 | Adriana Lopez | Technician | 2415 Reynolds Ave., Ste 100, N. Las Vegas, NV 89030 | 2020-03-11 |
| 1881234078 | Blanca E Rangel Silva | Technician | 2810 Equador Ct, Las Vegas, NV 89030 | 2020-01-15 |
| 1598314445 | Julia Gonzalez | Technician | 2415 Reynolds Ave Suiete 100, Las Vegas, NV 89030 | 2019-09-04 |
| 1487201901 | Mayra Gutierrez | Technician | 2415 Reynolds Av. #100, Las Vegas, NV 89030 | 2019-08-20 |
| 1639725799 | Idalia Ruiz | Technician | 2415 Reynolds Ave, Las Vegas, NV 89030 | 2019-08-14 |
| 1548815616 | Rd Prabhu-lata K Shete Mds Ltd | Clinic/Center | 1905 Civic Center Drive, Ste 201, N. Las Vegas, NV 89030 | 2019-08-06 |
| Find all providers in zip 89030 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497353627 | Justin Kent | Physician Assistant | 4521 Nantucket Clipper Dr, North Las Vegas, NV 89031-3492 | 2020-10-09 |
| 1316488141 | Fremont Emergency Services Mandavia Ltd | Physician Assistant | 7207 Aliante Parkway, North Las Vegas, NV 89128-0436 | 2017-03-13 |
| 1093254484 | Clkr | Physician Assistant | 2828 E. Lake Mead Blvd, North Las Vegas, NV 89030 | 2017-02-17 |
| 1477989168 | Jon-glen Allan Brown | Physician Assistant | 2404 Mountain Rail Dr, North Las Vegas, NV 89084-3128 | 2013-09-25 |
| 1528213840 | Kimberly Kakita | Physician Assistant | 1513 W Craig Rd Ste 105, North Las Vegas, NV 89032-0234 | 2008-12-01 |
| 1538202387 | Todd J Kuhnwald | Physician Assistant | 7204 Night Heron Way, North Las Vegas, NV 89084-2495 | 2007-02-14 |
| 1841373859 | Brian William Traugh | Physician Assistant | 2621 Losee Rd, North Las Vegas, NV 89030-4129 | 2006-10-23 |
| 1255429841 | Dennis James Fivecoat | Physician Assistant | 4511 W Cheyenne Ave, Ste 700, North Las Vegas, NV 89032-2450 | 2006-10-10 |
| 1952494619 | Tina Langeraap Martin | Physician Assistant | 1312 E Tonopah Ave, North Las Vegas, NV 89030-7111 | 2006-10-02 |
| 1689686578 | Brian E Lane | Physician Assistant | 47 W Owens Ave, North Las Vegas, NV 89030-6865 | 2006-08-12 |
| Find all providers in NORTH LAS VEGAS | ||||
| City | NORTH LAS VEGAS |
| Zip Code | 89030 |
Please comment or provide details below to improve the information on GUADALUPE R DOMINGUEZ.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.