Provider Demographics
NPI:1447533849
Name:ESPINAS, SEBASTIAN
Entity type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:
Last Name:ESPINAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 ROLAND WILEY RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-4719
Mailing Address - Country:US
Mailing Address - Phone:614-893-6773
Mailing Address - Fax:
Practice Address - Street 1:233 ROLAND WILEY RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-4719
Practice Address - Country:US
Practice Address - Phone:614-893-6773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17575183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist