Provider Demographics
NPI:1417794249
Name:AMPARO, INC
Entity type:Organization
Organization Name:AMPARO, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTIDA CORONA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-528-9828
Mailing Address - Street 1:2950 E FLAMINGO RD STE C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5208
Mailing Address - Country:US
Mailing Address - Phone:702-565-6004
Mailing Address - Fax:702-566-6009
Practice Address - Street 1:2950 E FLAMINGO RD STE C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5208
Practice Address - Country:US
Practice Address - Phone:702-565-6004
Practice Address - Fax:702-566-6009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)