Provider Demographics
NPI:1518107390
Name:SETAGHIAN, ANDRE MINAS (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:MINAS
Last Name:SETAGHIAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 MALEENA MESA ST APT 628
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8131
Mailing Address - Country:US
Mailing Address - Phone:818-606-6111
Mailing Address - Fax:
Practice Address - Street 1:4275 BURNHAM AVE STE 230
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5400
Practice Address - Country:US
Practice Address - Phone:702-487-7119
Practice Address - Fax:702-995-0033
Is Sole Proprietor?:No
Enumeration Date:2009-03-06
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVPA1150363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical