Provider Demographics
NPI:1356469761
Name:PATINO, GUILLERMO E (DO)
Entity Type:Individual
Prefix:DR
First Name:GUILLERMO
Middle Name:E
Last Name:PATINO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:8915 S PECOS RD STE 19A
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7150
Mailing Address - Country:US
Mailing Address - Phone:702-341-9000
Mailing Address - Fax:702-233-4799
Practice Address - Street 1:8915 S PECOS RD STE 19A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7150
Practice Address - Country:US
Practice Address - Phone:702-341-9000
Practice Address - Fax:702-233-4799
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ007111208800000X
NVCL0052208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty