Provider Demographics
NPI:1639841703
Name:DELGADILLO, PATRICK SETH
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:SETH
Last Name:DELGADILLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8879 W FLAMINGO RD STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8732
Mailing Address - Country:US
Mailing Address - Phone:516-532-3480
Mailing Address - Fax:702-701-9951
Practice Address - Street 1:5591 RITTER LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1350
Practice Address - Country:US
Practice Address - Phone:424-407-9640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant