Basic Information
| Provider Information | |||||||||
| NPI: | 1831377860 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUQAN | ||||||||
| FirstName: | ALIA | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 W. SECOND ST. | ||||||||
| Address2: | #235D / NELSON BLDG / MS 353 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7756828176 | ||||||||
| FaxNumber: | 7753272006 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 E. SECOND ST. | ||||||||
| Address2: | #302 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757847500 | ||||||||
| FaxNumber: | 7753275172 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2008 | ||||||||
| LastUpdateDate: | 04/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 15696 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | A103407 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | A103407 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207RG0300X | 15696 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1831377860 | 05 | CA | MEDICAID |