Provider Demographics
NPI:1649487257
Name:VALERA, AMIT (DO)
Entity type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:VALERA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10155 W TWAIN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6723
Mailing Address - Country:US
Mailing Address - Phone:702-848-5644
Mailing Address - Fax:702-848-5415
Practice Address - Street 1:10155 W TWAIN AVE STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6723
Practice Address - Country:US
Practice Address - Phone:702-848-5644
Practice Address - Fax:702-848-5415
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1528208M00000X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty