Healthcare Provider Details

I. General information

NPI: 1134289002
Provider Name (Legal Business Name): DR. CYNTHIA ANN SOLBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 KIETZKE LN STE 103
RENO NV
89511-2063
US

IV. Provider business mailing address

5420 KIETZKE LN STE 103
RENO NV
89511-2063
US

V. Phone/Fax

Practice location:
  • Phone: 775-359-2020
  • Fax: 775-359-2676
Mailing address:
  • Phone: 775-359-2020
  • Fax: 775-359-2676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberNV468
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: