Provider Demographics
NPI:1265614424
Name:ONE SANTA FE CORPORATION
Entity type:Organization
Organization Name:ONE SANTA FE CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CARMINA ARRASITA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-798-3008
Mailing Address - Street 1:10087 CANYON HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-7646
Mailing Address - Country:US
Mailing Address - Phone:702-798-3008
Mailing Address - Fax:702-869-4763
Practice Address - Street 1:4240 SIMMONS ST
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-0766
Practice Address - Country:US
Practice Address - Phone:702-575-3787
Practice Address - Fax:702-449-7906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVI25102Medicare UPIN