Provider Demographics
NPI:1003379017
Name:ZELAYA, DANIEL A
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:ZELAYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 NAVAJO LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-2521
Mailing Address - Country:US
Mailing Address - Phone:702-972-7293
Mailing Address - Fax:
Practice Address - Street 1:2427 CLIFFORD AVE APT 8
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-2135
Practice Address - Country:US
Practice Address - Phone:702-738-9916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant