Basic Information
| Provider Information | |||||||||
| NPI: | 1922242676 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MACHUCA | ||||||||
| FirstName: | FRANCISCO | ||||||||
| MiddleName: | GUADALUPE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 S EASTERN AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891043916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027787614 | ||||||||
| FaxNumber: | 7027787615 | ||||||||
| Practice Location | |||||||||
| Address1: | 1513 S EASTERN AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891043916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7027787614 | ||||||||
| FaxNumber: | 7027787615 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/25/2009 | ||||||||
| LastUpdateDate: | 02/12/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 26368 | NE | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 16108 | NV | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.