Alta Medical Clinic Inc of Nevada

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ALTA MEDICAL CLINIC INC OF NEVADA

Practice address

1500 E Tropicana Ave Ste 163
Las Vegas, NV 89119-6516

Phone

(626) 705-1005

NPI assigned

Sep 20, 2022

Last updated

Sep 20, 2022By 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

Gladelynn Adlao, APRN

Title

Vice President

Phone

(626) 705-1005

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1376266833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E TROPICANA AVE STE 163",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196516",
            "telephone_number": "626-705-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E TROPICANA AVE STE 163",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196516",
            "telephone_number": "626-705-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA MEDICAL CLINIC INC OF NEVADA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "ADLAO",
        "authorized_official_first_name": "GLADELYNN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "626-705-1005",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alta Medgen NV LLC
• Alta Oral Surgery, LLC
• Alta Wellness Center LLC
• Alta-Rose Surgery Center LLC
• Joelita Altabet
• Angelina Marie Altaf

• General Practice Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• General Practice Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.