Grace Cano-Debelen, MD

Individual provider Active NPI Pediatrics Physician · Las Vegas, NV

NPI 1679599013 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1679599013
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
10006 (NV)
Practice address
4375 S Buffalo Dr
Ste 101
Las Vegas, NV 89147
Phone
(702) 894-9422
Fax
(902) 894-9258
NPI assigned
Jul 15, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Valley Medical Center Past Accepting new patients
Healthwell Medical Group Pediatrics Past
since Mar 1, 2003
Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 10006 NV Yes

Addresses

Primary practice location

4375 S Buffalo Dr
Ste 101
Las Vegas, NV 89147

Mailing address

PO Box 82277
Las Vegas, NV 89180
Phone (702) 894-9422

Other names

  • Grace Cano Professional name

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Pediatrics Physician in Nevada

Sources for this page

Verify at the official NPI Registry.