Basic Information
| Provider Information | |||||||||
| NPI: | 1790766798 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARRAIZ | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | JOSE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6255 SHARLANDS AVE | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895232882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757863040 | ||||||||
| FaxNumber: | 7757885242 | ||||||||
| Practice Location | |||||||||
| Address1: | 6255 SHARLANDS AVE | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895232882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752456117 | ||||||||
| FaxNumber: | 7752456118 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2005 | ||||||||
| LastUpdateDate: | 11/11/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 9611 | NV | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | XPY199375 | 01 | CA | MEDI-CAL PIN | OTHER | 20-16904 | 05 | NV | MEDICAID | 250013236 | 01 | NV | RAILROAD MEDICARE | OTHER |