Provider Demographics
NPI:1871837526
Name:BEJAR, ALFREDO
Entity Type:Individual
Prefix:MR
First Name:ALFREDO
Middle Name:
Last Name:BEJAR
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 1:10166 JUNE FLOWER DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-8521
Mailing Address - Country:US
Mailing Address - Phone:702-815-3142
Mailing Address - Fax:
Practice Address - Street 1:10166 JUNE FLOWER DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-8521
Practice Address - Country:US
Practice Address - Phone:702-815-3142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner