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
-
Farber, Leslie
7575 W Washington Ave Ste 127, Las Vegas NV 89128 -
Zheng, Wei Feng
7918 W Sahara Ave , Las Vegas NV 89117-1990 -
Nnadi, Evarista C
2410 Fire Mesa St #180, Las Vegas NV 89128-9016 -
Plunkett, Earl K
1480 S 7Th St , Las Vegas NV 89104-1633 -
Pennelle, Donald Kenneth
700 Shadow Ln Ste 470, Las Vegas NV 89106-4159 -
Rivas, David M
821 N Nellis Blvd , Las Vegas NV 89110-5339 -
Flora, Nicole R.
3201 S Maryland Pkwy Suite 400, Las Vegas NV 89109-2441 -
Cho, Young
4475 S Eastern Ave , Las Vegas NV 89119-7826