| |
7111 S Virginia St Ste D2, Reno, NV 89511-1141 | |
(775) 870-1230 | |
(833) 606-1557 |
Full Name | |
---|---|
Type | Facility |
Speciality | Psychiatry & Neurology - Neurology |
Location | 7111 S Virginia St Ste D2, Reno, Nevada |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033773130 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NN0400X | Chiropractor - Neurology | (* (Not Available)) | Secondary |
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Rachael Gardner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1992093272 PECOS PAC ID: 3577797646 Enrollment ID: I20131002000556 |
Provider Name | Byung Chan Thomas Ahn |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1962701219 PECOS PAC ID: 5890096374 Enrollment ID: I20181016002893 |
Mailing Address | Practice Location Address |
---|---|
135 N Sierra St # 40595, Reno, NV 89501-1344 Ph: (775) 870-1230 | 7111 S Virginia St Ste D2, Reno, NV 89511-1141 Ph: (775) 870-1230 |