Aleli Vidad MD, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

12435 Issued in NV

Legal business name

ALELI VIDAD MD, INC

Practice address

501 N. Navajo Dr
Page, AZ 86040

Phone

(775) 883-3336

Fax

(775) 883-0877

NPI assigned

Mar 6, 2012

Last updated

Mar 6, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aleli Favila Vidad, MD

Title

MD

Phone

(775) 881-8543

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1346514585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4477",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897024477",
            "telephone_number": "775-883-3336",
            "fax_number": "775-883-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N. NAVAJO DR",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "86040",
            "telephone_number": "775-883-3336",
            "fax_number": "775-883-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALELI VIDAD MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-06",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "VIDAD",
        "authorized_official_first_name": "ALELI",
        "authorized_official_middle_name": "FAVILA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "775-881-8543",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "12435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1750576245",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Page, AZ
• Providers in Page, AZ by specialty
• Specialist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.