FRED FOMBRUN (NPI# 1730590829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730590829 |
Entity Type | Individual |
Full Name | FRED FOMBRUN |
Credential | PA-C |
Practice Address |
2380 W Horizon Ridge Pkwy Ste 110 Henderson NV 89052-5078 |
Mailing Address |
205 Winnsboro St Henderson NV 89074-7877 |
Practice Telephone | 9726560493 |
Mailing Telephone | 8627559418 |
Enumeration Date | 2014-05-12 |
Last Update Date | 2014-05-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA1527 | NV | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
2380 W HORIZON RIDGE PKWY STE 110 |
City | HENDERSON |
State | NV |
Zip Code | 89052-5078 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619293495 | Miguel Angel Mendoza Navarro | Emergency Medicine | 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 | 2010-04-19 |
1336511476 | Carlos Justin Aguon Esparza | Nurse Practitioner | 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 | 2015-10-28 |
1992176044 | Michelle Norvell | Nurse Practitioner | 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 | 2015-10-15 |
1912390196 | Jiji Ochoa | Nurse Practitioner | 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 | 2015-03-11 |
1386042182 | Joshua Michael Atiyeh | Physician Assistant | 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 | 2014-12-09 |
1376966192 | Terry Lynn Bartmus | Nurse Practitioner | 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 | 2014-01-30 |
1306135710 | David M Hart | Emergency Medicine | 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 | 2011-04-06 |
1801116249 | Patrick John Frank | Emergency Medicine | 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 | 2010-06-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740889112 | Nathan Michael Nasternak | Physical Therapist | 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 | 2020-10-18 |
1558987180 | Braxton Chad Storm | Counselor | 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 | 2020-06-19 |
1558996546 | The Eye Doctor At St. Rose LLC | Eyewear Supplier (Equipment, not the service) | 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 | 2020-03-10 |
1770138521 | Quinn Dentists of St. Rose, PC | Dentist | 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 | 2019-08-08 |
1346802568 | Rickie Kwong Chin Jr. | Optometrist | 695 S. Green Valley Pkwy, Henderson, NV 89052 | 2019-07-08 |
1134695646 | Nu Smiles, LLC | Clinic/Center | 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 | 2018-10-23 |
1003393497 | Katherine Lee Villarreal | Physical Therapist | 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 | 2018-07-27 |
1790281889 | Vicki Lorraine Schmidt | Nurse Practitioner | 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 | 2018-04-05 |
1326566969 | Shelby Schiller | Social Worker | 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 | 2017-09-04 |
1639696826 | Pca Ventures, LLC | Technician | 2656 Soda Butte Court, Henderson, NV 89052 | 2017-08-28 |
Find all providers in zip 89052 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144618349 | Dinesh Bharwani | Physician Assistant | 270 West Lake Mead Parkway, Southwest Medical Associates, Henderson, NV 89015 | 2014-12-23 |
1285057562 | Elena Zalan | Physician Assistant | 75 S Valle Verde Dr, Suite 100, Henderson, NV 89012-3462 | 2014-01-22 |
1760557151 | Leda W.z. Edwards | Physician Assistant | 6301 Mountain Vista, Suite #205, Henderson, NV 89014 | 2006-11-21 |
1952381089 | Ronald Allen Hoffmeyer | Physician Assistant | 1132 Industrial Drive, Henderson Health Center, Henderson, TN 38340 | 2006-01-17 |
1750997078 | Els Dauven | Physician Assistant | 10950 S Eastern Ave Ste 100, Henderson, NV 89052-4971 | 2020-09-22 |
1952926297 | Dana Shepherd | Physician Assistant | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2020-06-12 |
1861957722 | Michaela R Parrish | Physician Assistant | 1621 Front St, Henderson, NE 68371-8902 | 2019-02-05 |
1770056566 | Justin Peter Spangler | Physician Assistant | 2900 N Green Valley Pkwy, Henderson, NV 89014-0410 | 2019-01-04 |
1396217493 | Audrey N Darreguet | Physician Assistant | 10001 S Eastern Ave Ste 310, Henderson, NV 89052-3908 | 2018-12-30 |
1871082511 | Robert Wimmer | Physician Assistant | 874 American Pacific Dr, Henderson, NV 89014-8800 | 2018-05-08 |
Find all providers in HENDERSON |
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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.