| Doctor Name: | DR. JOSELO ATIENZA VICUNA |
| NPI Number: | 1033201082 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 3370 |
| Business Practice Address: | 2365 Reynolds Ave 211 North Las Vegas, NV - 890307276 |
| Business Phone Number: | 7023991287 |
| Business Fax Number: | 7026498064 |
| Mailing Address: | Po Box 98978, LAS VEGAS |
| State: | NV |
| Postal Code: | 891938978 |
| Phone Number: | 7025072486 |
| Fax Number: | 7026716883 |
| NPI Enumeration Date: | 09/28/2006 |
| NPI Last Update Date: | 01/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 3370 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |