Basic Information
| Provider Information | |||||||||
| NPI: | 1427004167 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DEVEN KHOSLA MD LTD | ||||||||
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| Address1: | 85 KIRMAN AVE | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895021339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753232080 | ||||||||
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| Practice Location | |||||||||
| Address1: | 85 KIRMAN AVE | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895021339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753232080 | ||||||||
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| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KHOSLA | ||||||||
| AuthorizedOfficialFirstName: | DEVEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7753232080 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 9803 | NV | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.