Provider Demographics
NPI:1205809720
Name:HAMOR, PAUL LEYVA (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:LEYVA
Last Name:HAMOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15645
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89114-5645
Mailing Address - Country:US
Mailing Address - Phone:702-242-7308
Mailing Address - Fax:702-240-8790
Practice Address - Street 1:4500 W OAKEY BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1527
Practice Address - Country:US
Practice Address - Phone:702-873-5110
Practice Address - Fax:702-873-8093
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506660Medicaid
NVP00291534OtherRAILROAD MEDICARE
NV002016590Medicaid
NV6333OtherNV STATE LICENSE
NV1205809720Medicaid