Provider Demographics
NPI:1457306847
Name:PLATON, PACITA (MD)
Entity Type:Individual
Prefix:
First Name:PACITA
Middle Name:
Last Name:PLATON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1980
Mailing Address - Street 2:FALLON TRIBAL HEALTH CENTER
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89407-1980
Mailing Address - Country:US
Mailing Address - Phone:775-423-3634
Mailing Address - Fax:775-423-5694
Practice Address - Street 1:1001 RIO VISTA DR
Practice Address - Street 2:FALLON TRIBAL HEALTH CENTER
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-5463
Practice Address - Country:US
Practice Address - Phone:775-423-3634
Practice Address - Fax:775-423-5694
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV7597208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV004716904Medicaid
NV003116904Medicaid