Basic Information
| Provider Information | |||||||||
| NPI: | 1396386991 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RENO ORTHOPAEDIC CLINIC INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 555 N ARLINGTON AVE | ||||||||
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| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895034723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757863040 | ||||||||
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| Practice Location | |||||||||
| Address1: | 75 PRINGLE WAY STE 701 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895021472 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757863040 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2019 | ||||||||
| LastUpdateDate: | 10/04/2019 | ||||||||
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| AuthorizedOfficialLastName: | UPPAL | ||||||||
| AuthorizedOfficialFirstName: | RENNY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7757863040 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.