Healthcare Provider Details

I. General information

NPI: 1376478321
Provider Name (Legal Business Name): CYRUS DEMETRIOS MOASSESSI OMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6170 RIDGEVIEW CT STE C
RENO NV
89519-6331
US

IV. Provider business mailing address

6170 RIDGEVIEW CT STE C
RENO NV
89519-6331
US

V. Phone/Fax

Practice location:
  • Phone: 775-329-5100
  • Fax:
Mailing address:
  • Phone: 775-329-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2530
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: