Provider Demographics
NPI:1689295537
Name:REGENERATIVE CELL INSTITUTE
Entity Type:Organization
Organization Name:REGENERATIVE CELL INSTITUTE
Other - Org Name:REGENERATIVE CELL INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-550-3083
Mailing Address - Street 1:2911 N TENAYA WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0495
Mailing Address - Country:US
Mailing Address - Phone:702-550-3083
Mailing Address - Fax:702-550-3079
Practice Address - Street 1:2911 N TENAYA WAY STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0495
Practice Address - Country:US
Practice Address - Phone:702-550-3083
Practice Address - Fax:702-550-3079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty