FRED FOMBRUN


Address: 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078
Phone: 9726560493

FRED FOMBRUN (NPI# 1730590829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1730590829
Entity Type Individual
Full Name FRED FOMBRUN
Credential PA-C
Practice Address 2380 W Horizon Ridge Pkwy Ste 110
Henderson
NV 89052-5078
Mailing Address 205 Winnsboro St
Henderson
NV 89074-7877
Practice Telephone 9726560493
Mailing Telephone 8627559418
Enumeration Date 2014-05-12
Last Update Date 2014-05-12
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA1527 NV Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2380 W HORIZON RIDGE PKWY STE 110
City HENDERSON
State NV
Zip Code 89052-5078

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619293495 Miguel Angel Mendoza Navarro Emergency Medicine 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 2010-04-19
1336511476 Carlos Justin Aguon Esparza Nurse Practitioner 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 2015-10-28
1992176044 Michelle Norvell Nurse Practitioner 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 2015-10-15
1912390196 Jiji Ochoa Nurse Practitioner 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 2015-03-11
1386042182 Joshua Michael Atiyeh Physician Assistant 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 2014-12-09
1376966192 Terry Lynn Bartmus Nurse Practitioner 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 2014-01-30
1306135710 David M Hart Emergency Medicine 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 2011-04-06
1801116249 Patrick John Frank Emergency Medicine 2380 W Horizon Ridge Pkwy Ste 110, Henderson, NV 89052-5078 2010-06-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1740889112 Nathan Michael Nasternak Physical Therapist 750 Coronado Center Drive, Suite 140, 2212, Henderson, NV 89052 2020-10-18
1558987180 Braxton Chad Storm Counselor 2990 W. Sundridge Heights Pkwy, Suite #140, Henderson, NV 89052 2020-06-19
1558996546 The Eye Doctor At St. Rose LLC Eyewear Supplier (Equipment, not the service) 2645 St. Rose Parkway, Suite C-110, Henderson, NV 89052 2020-03-10
1770138521 Quinn Dentists of St. Rose, PC Dentist 3519 St Rose Parkway, Ste 110, Henderson, NV 89052 2019-08-08
1346802568 Rickie Kwong Chin Jr. Optometrist 695 S. Green Valley Pkwy, Henderson, NV 89052 2019-07-08
1134695646 Nu Smiles, LLC Clinic/Center 2810 W. Horizon Ridge Parkway, Suite #110, Henderson, NV 89052 2018-10-23
1003393497 Katherine Lee Villarreal Physical Therapist 2930 W Horizon Pkwy, Suite 205, Henderson, NV 89052 2018-07-27
1790281889 Vicki Lorraine Schmidt Nurse Practitioner 2900 W. Horizon Ridge Pkwy, Suite 101, Henderson, NV 89052 2018-04-05
1326566969 Shelby Schiller Social Worker 3051 W Horizon Ridge Pkwy Ste 104a, Henderson, NV 89052 2017-09-04
1639696826 Pca Ventures, LLC Technician 2656 Soda Butte Court, Henderson, NV 89052 2017-08-28
Find all providers in zip 89052

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144618349 Dinesh Bharwani Physician Assistant 270 West Lake Mead Parkway, Southwest Medical Associates, Henderson, NV 89015 2014-12-23
1285057562 Elena Zalan Physician Assistant 75 S Valle Verde Dr, Suite 100, Henderson, NV 89012-3462 2014-01-22
1760557151 Leda W.z. Edwards Physician Assistant 6301 Mountain Vista, Suite #205, Henderson, NV 89014 2006-11-21
1952381089 Ronald Allen Hoffmeyer Physician Assistant 1132 Industrial Drive, Henderson Health Center, Henderson, TN 38340 2006-01-17
1750997078 Els Dauven Physician Assistant 10950 S Eastern Ave Ste 100, Henderson, NV 89052-4971 2020-09-22
1952926297 Dana Shepherd Physician Assistant 874 American Pacific Dr, Henderson, NV 89014-8800 2020-06-12
1861957722 Michaela R Parrish Physician Assistant 1621 Front St, Henderson, NE 68371-8902 2019-02-05
1770056566 Justin Peter Spangler Physician Assistant 2900 N Green Valley Pkwy, Henderson, NV 89014-0410 2019-01-04
1396217493 Audrey N Darreguet Physician Assistant 10001 S Eastern Ave Ste 310, Henderson, NV 89052-3908 2018-12-30
1871082511 Robert Wimmer Physician Assistant 874 American Pacific Dr, Henderson, NV 89014-8800 2018-05-08
Find all providers in HENDERSON

Competitor

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City HENDERSON
Zip Code 89052

Improve Information

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Dataset Information

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.

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