Provider Demographics
NPI:1477518801
Name:PARTIDA CORONA, JOSE MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:MARIA
Last Name:PARTIDA CORONA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2950 E FLAMINGO RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5208
Mailing Address - Country:US
Mailing Address - Phone:702-565-6004
Mailing Address - Fax:702-566-6009
Practice Address - Street 1:2950 E FLAMINGO RD
Practice Address - Street 2:SUITE E
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5208
Practice Address - Country:US
Practice Address - Phone:702-565-6004
Practice Address - Fax:702-566-6009
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2023-04-21
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Provider Licenses
StateLicense IDTaxonomies
NV116392083A0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1477518801Medicaid
NV1477518801Medicaid
NVI46475Medicare UPIN