Provider Demographics
NPI:1346340429
Name:OSCAR A BATUGAL A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:OSCAR A BATUGAL A PROFESSIONAL CORPORATION
Other - Org Name:DESERT VALLEY MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:AQUINO
Authorized Official - Last Name:BATUGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-382-7760
Mailing Address - Street 1:2501 W CHARLESTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2127
Mailing Address - Country:US
Mailing Address - Phone:702-382-7760
Mailing Address - Fax:702-382-7871
Practice Address - Street 1:2501 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2127
Practice Address - Country:US
Practice Address - Phone:702-382-7760
Practice Address - Fax:702-382-7871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2009-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8269207R00000X
NV8763207R00000X
NV9921207R00000X
NV10170207R00000X
NV111062084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV34702Medicare PIN