Provider Demographics
NPI:1811433113
Name:PINZON, ANGELA ROCIO
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:ROCIO
Last Name:PINZON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:ROCIO
Other - Last Name:VARGAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8636 BUTTERCREEK WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5504
Mailing Address - Country:US
Mailing Address - Phone:619-929-8613
Mailing Address - Fax:
Practice Address - Street 1:9025 W DESERT INN RD APT 262
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-6310
Practice Address - Country:US
Practice Address - Phone:619-929-8613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor