Gaspar De Alba, Mario J.
Gaspar De Alba, Mario J. is an individual health care provider with primary practice located at 630 S Rancho Dr Ste A , Las Vegas NV 89106-4849. He recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as his primary health care specialty. Gaspar De Alba, Mario J. can be contacted via phone (702) 998-9505.Contact Information
Primary practice address
630 S Rancho Dr Ste A
Las Vegas NV 89106-4849
Phone: (702) 998-9505
Fax: (702) 527-7939
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | M3232 | Texas |
| Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | 14554 | Nevada |
Profile Details
| NPI number | 1275546590 |
|---|---|
| LBN Legal business name | Gaspar De Alba, Mario J. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2006 |
| Last updated | Jun 2nd, 2020 - about 4 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 | 1275546590 | NPPES |
| Nevada | MEDICAID | 1275546590 | |
| Nevada | MEDICAID | 178999201 | |
| Nevada | Other | GW226Z | |
| Nevada | Other | 8H0437 |
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