Fontillas, Ricardo Allen

Fontillas, Ricardo Allen is an individual health care provider with primary practice located at 1090 Wigwam Pkwy Suite 100, Henderson NV 89074-8181. He recently has only one registered license in Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, which is considered as his primary health care specialty. Fontillas, Ricardo Allen can be contacted via phone (702) 454-0201.

Contact Information

Primary practice address
1090 Wigwam Pkwy Suite 100 Henderson NV 89074-8181
Phone: (702) 454-0201
Fax: (702) 454-1245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 6501 Nevada

Profile Details

NPI number 1982629762
LBN Legal business name Fontillas, Ricardo Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Nov 15th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982629762 NPPES
Nevada MEDICAID 002019612

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