Deshazo, Gary Max
Deshazo, Gary Max is an sole proprietor health care provider with primary practice located at 2901 N Tenaya Way Ste 100 , Las Vegas NV 89128-1404. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine, Ambulatory Health Care Facilities / Community Health, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Deshazo, Gary Max can be contacted via phone (702) 870-8852.Contact Information
Primary practice address
2901 N Tenaya Way Ste 100
Las Vegas NV 89128-1404
Phone: (702) 870-8852
Fax: (702) 870-8914
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine | 2083P0901X | 380 | Nevada |
| Ambulatory Health Care Facilities / Community Health | 261QC1500X | 380 | Nevada |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 380 | Nevada |
Profile Details
| NPI number | 1568512101 |
|---|---|
| LBN Legal business name | Deshazo, Gary Max |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 12th, 2007 |
| Last updated | Feb 17th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568512101 | NPPES |
| Nevada | Other | CC4619 | BLUE CROSS PIN |
| Nevada | MEDICAID | 002002672 | BLUE CROSS PIN |
Popular Providers
-
Zheng, Wei Feng
7918 W Sahara Ave , Las Vegas NV 89117-1990 -
Capobianco, Leo Joseph
2801 N Tenaya Way Ste C , Las Vegas NV 89128-1400 -
Bhogineni-Thakore, Susmita
650 N Nellis Blvd , Las Vegas NV 89110 -
Pennelle, Donald Kenneth
700 Shadow Ln Ste 470, Las Vegas NV 89106-4159 -
Plunkett, Earl K
1480 S 7Th St , Las Vegas NV 89104-1633 -
Nnadi, Evarista C
2410 Fire Mesa St #180, Las Vegas NV 89128-9016 -
Bauzon, Samuel
7061 Grand Montecito Pkwy , Las Vegas NV 89149-0287 -
Rivas, David M
821 N Nellis Blvd , Las Vegas NV 89110-5339