Provider Demographics
NPI:1053651091
Name:HOUSE CALL DR REGALADO PLLC
Entity Type:Organization
Organization Name:HOUSE CALL DR REGALADO PLLC
Other - Org Name:HEART TO HOME DOCTOR
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA CORAZON
Authorized Official - Middle Name:O
Authorized Official - Last Name:REGALADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-876-0350
Mailing Address - Street 1:1811 S RAINBOW BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-0037
Mailing Address - Country:US
Mailing Address - Phone:702-876-0350
Mailing Address - Fax:702-876-1090
Practice Address - Street 1:1811 S RAINBOW BLVD STE 108
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-876-0350
Practice Address - Fax:702-847-7437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8966207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV8966OtherMEDICAL LICENSE