Diedrich, Paul

Diedrich, Paul is an individual health care provider with primary practice located at 7061 Grand Montecito Pkwy , Las Vegas NV 89149-0287. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Diedrich, Paul can be contacted via phone (702) 877-5199.

Contact Information

Primary practice address
7061 Grand Montecito Pkwy Las Vegas NV 89149-0287
Phone: (702) 877-5199
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA870 Nevada

Profile Details

NPI number 1841260742
LBN Legal business name Diedrich, Paul
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Sep 3rd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841260742 NPPES
Nevada MEDICAID 100504092
Nevada MEDICAID 100504091

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