Provider Demographics
NPI:1376578674
Name:SAQUETON, CONSOLACION SAQUETON (MD)
Entity Type:Individual
Prefix:
First Name:CONSOLACION
Middle Name:SAQUETON
Last Name:SAQUETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CONSOLACION
Other - Middle Name:SAQUETON
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 371540
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-1540
Mailing Address - Country:US
Mailing Address - Phone:702-383-2420
Mailing Address - Fax:702-383-8402
Practice Address - Street 1:1800 W CHARLESTON BLVD - UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2329
Practice Address - Country:US
Practice Address - Phone:702-383-2420
Practice Address - Fax:702-383-8402
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV93942080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV20118174Medicaid
OR274900Medicaid
AZ570805Medicaid
PA101466763Medicaid
CAXPY197225Medicaid
WA8265969Medicaid
TX1489049Medicaid
0TH00Medicare UPIN