Provider Demographics
NPI:1043305360
Name:SAAVEDRA, RUBIN (MD)
Entity Type:Individual
Prefix:
First Name:RUBIN
Middle Name:
Last Name:SAAVEDRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 ALMOND TREE LN
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3233
Mailing Address - Country:US
Mailing Address - Phone:702-657-3873
Mailing Address - Fax:702-636-0787
Practice Address - Street 1:1140 ALMOND TREE LN
Practice Address - Street 2:SUITE 306
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3233
Practice Address - Country:US
Practice Address - Phone:702-657-3873
Practice Address - Fax:702-636-0787
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8907207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018167Medicaid
NVG64076Medicare UPIN