Provider Demographics
NPI:1922185396
Name:TOMBURO, TODD ALEXANDER (DC)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:ALEXANDER
Last Name:TOMBURO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 E CHEYENNE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-5016
Mailing Address - Country:US
Mailing Address - Phone:702-642-9672
Mailing Address - Fax:702-642-9682
Practice Address - Street 1:2501 E CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5016
Practice Address - Country:US
Practice Address - Phone:702-642-9672
Practice Address - Fax:702-642-9682
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00532111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U85647Medicare UPIN