Provider Demographics
NPI:1538504394
Name:DELAPPI PHYSICIAN ASSISTANT SERVICES LLC
Entity Type:Organization
Organization Name:DELAPPI PHYSICIAN ASSISTANT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:DELAPPI
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:702-496-6985
Mailing Address - Street 1:8550 W DESERT INN RD
Mailing Address - Street 2:STE. 102-425
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4401
Mailing Address - Country:US
Mailing Address - Phone:702-496-6985
Mailing Address - Fax:702-925-7077
Practice Address - Street 1:8550 W DESERT INN RD
Practice Address - Street 2:STE. 102-425
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4401
Practice Address - Country:US
Practice Address - Phone:702-496-6985
Practice Address - Fax:702-925-7077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20131018943363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty