Provider Demographics
NPI:1194026641
Name:PINON, MONICA NADINE (OD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:NADINE
Last Name:PINON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 W LAKE MEAD BLVD
Mailing Address - Street 2:#465
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0297
Mailing Address - Country:US
Mailing Address - Phone:510-205-7212
Mailing Address - Fax:
Practice Address - Street 1:4355 S GRAND CANYON DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-7106
Practice Address - Country:US
Practice Address - Phone:702-917-1694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-14
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV692152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist