Provider Demographics
NPI:1912086851
Name:SEBASTIAN L ORNOPIA MD LLC
Entity Type:Organization
Organization Name:SEBASTIAN L ORNOPIA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEBASTIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ORNOPIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-396-8834
Mailing Address - Street 1:889 S RAINBOW BLVD
Mailing Address - Street 2:#647
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-6238
Mailing Address - Country:US
Mailing Address - Phone:702-396-8834
Mailing Address - Fax:702-396-6550
Practice Address - Street 1:5460 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3307
Practice Address - Country:US
Practice Address - Phone:702-396-8834
Practice Address - Fax:702-396-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV114632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507163Medicaid
NV100507163Medicaid