Provider Demographics
NPI:1679380851
Name:GE ACUNA MEDICAL SERVICES PLLC
Entity type:Organization
Organization Name:GE ACUNA MEDICAL SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:P
Authorized Official - Last Name:GE ACUNA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:702-980-1489
Mailing Address - Street 1:2137 KAPOK TREE LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-0789
Mailing Address - Country:US
Mailing Address - Phone:702-980-1489
Mailing Address - Fax:
Practice Address - Street 1:2020 E DESERT INN RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3211
Practice Address - Country:US
Practice Address - Phone:702-980-1489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-12
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care