MUJICA TRENCHE - VITALITY MD PC (NPI# 1720355621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720355621 |
| Entity Type | Organization |
| Organization Name | MUJICA TRENCHE - VITALITY MD PC |
| Other Organization Name | STOCKRIDGE MEN'S MEDCENTER |
| Practice Address |
6380 W Flamingo Rd Ste A Las Vegas NV 89103-7129 |
| Mailing Address |
Po Box 521 Andover KS 67002-0521 |
| Practice Telephone | 7028880052 |
| Mailing Telephone | 3169273884 |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2012-03-16 |
| Authorized Official Name | DR. SAMUEL A MUJICA TRENCHE (SOLE MEMBER) |
| Authorized Official Telephone | 7028880052 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Stockridge Men's MedCenter | Doing Business As Name - Organization |
| Street Address |
6380 W FLAMINGO RD STE A |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89103-7129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043821671 | New Directions LLC | Counselor | 3651 S Lindell Dr, Ste D15 B, Las Vegas, NV 89103 | 2020-08-17 |
| 1396356929 | A-plus Community Counseling Services LLC | Counselor | 3651 S Lindell Dr Ste D15, Las Vegas, NV 89103 | 2020-08-17 |
| 1437798931 | Las Vegas Diagnostic & Treatment LLC | Neuromusculoskeletal Medicine & OMM | Dpm, 5650 W Flamingo Rd Ste A, Las Vegas, NV 89103 | 2019-12-31 |
| 1033769385 | Maria Yemi Centeno | Technician | 4674 Via Torino, Las Vegas, NV 89103 | 2019-09-18 |
| 1750847869 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3821 W Flamingo Rd, Las Vegas, NV 89103 | 2019-02-13 |
| 1447741905 | Adgold Medical Corp | Durable Medical Equipment & Medical Supplies | 3651 Lindell Rd Ste D536, Las Vegas, NV 89103 | 2018-05-21 |
| 1184138620 | Kiley Ballew | Social Worker | 4425 South Jones, Suite D3, Las Vegas, NV 89103 | 2017-11-20 |
| 1396275988 | Karen Walton | Technician | 5419 W. Tropicana Ave. A2803, Las Vegas, NV 89103 | 2017-06-15 |
| 1760923643 | Shannon-dorothy Austria | Social Worker | 4425 S. Jones, Suite D3, Las Vegas, NV 89103 | 2017-03-13 |
| 1306260583 | Ladonna Smith | Behavioral Analyst | 1126 Tamerck Ave, Las Vegas, NV 89103 | 2014-02-10 |
| Find all providers in zip 89103 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134660137 | New Image Medical Inc. | Urology | 2610 S Jones Blvd Ste B, Las Vegas, NV 89146-5663 | 2017-03-10 |
| 1841532595 | Robert James Evans | Urology | 2353 Lauren Dr, Las Vegas, NV 89134-5533 | 2013-03-20 |
| 1720213101 | Joel Emmanuel Abbott | Urology | 6110 Elton Ave, Las Vegas, NV 89107-2538 | 2009-05-28 |
| 1497977334 | Avi Weiss | Urology | 3150n Tenaya Way 165, Las Vegas, NV 89128-0462 | 2007-05-02 |
| 1366537144 | Jeffrey M. Zapinsky | Urology | 7200 Cathedral Rock Dr., Suite 180, Las Vegas, NV 89128-0466 | 2006-10-04 |
| 1659483444 | Sheldon Jay Freedman | Urology | 653 N Town Center Dr Ste 308, Las Vegas, NV 89144-0517 | 2006-08-31 |
| 1245242957 | Omid A. Lesani | Urology | 7500 Smoke Ranch Rd., Suite 200, Las Vegas, NV 89128-0373 | 2006-08-12 |
| 1578509949 | Helen T Housley | Urology | 2000 Pinto Ln, Suite 200, Las Vegas, NV 89106-4045 | 2006-06-22 |
| 1659328391 | Sarah A. Ryan | Urology | 3150 N Tenaya Way Ste 165, Las Vegas, NV 89128-0462 | 2006-05-28 |
| 1245216605 | Jayram Krishnan | Urology | 3131 La Canada St, Suite 217, Las Vegas, NV 89169-2578 | 2005-12-19 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.