Provider Demographics
NPI:1407193121
Name:CARUNGCONG-OTADO, ARLENE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:
Last Name:CARUNGCONG-OTADO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:
Other - Last Name:CARUNGCONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7140 SMOKE RANCH RD STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-3157
Mailing Address - Country:US
Mailing Address - Phone:702-839-4810
Mailing Address - Fax:702-483-2269
Practice Address - Street 1:7140 SMOKE RANCH RD
Practice Address - Street 2:SUITE 150
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-3157
Practice Address - Country:US
Practice Address - Phone:702-320-8111
Practice Address - Fax:702-320-8112
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA1410363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant