Provider Demographics
NPI:1750853495
Name:RHINO, ISAAC RAPHAEL (CSFA)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:RAPHAEL
Last Name:RHINO
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6671 LAS VEGAS BLVD S UNIT D-210
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-3273
Mailing Address - Country:US
Mailing Address - Phone:702-800-6451
Mailing Address - Fax:
Practice Address - Street 1:10739 KNICKERBOCKER AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-8009
Practice Address - Country:US
Practice Address - Phone:702-290-6260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV187046246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant