Basic Information
| Provider Information | |||||||||
| NPI: | 1912438763 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIPRINZIO | ||||||||
| FirstName: | DOMINIC | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 RANCH LANE | ||||||||
| Address2: | SUITE 135 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89106 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 901 RANCH LANE | ||||||||
| Address2: | SUITE 135 | ||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023837885 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2017 | ||||||||
| LastUpdateDate: | 11/18/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | DO2691 | NV | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.