Healthcare Provider Details

I. General information

NPI: 1720123045
Provider Name (Legal Business Name): EUGENE MICHAEL KALIN MD FRCP (C )
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1474 CORONET DR
RENO NV
89509-3507
US

IV. Provider business mailing address

1474 CORONET DR
RENO NV
89509-3507
US

V. Phone/Fax

Practice location:
  • Phone: 775-786-6851
  • Fax: 775-322-5379
Mailing address:
  • Phone: 775-786-6851
  • Fax: 775-322-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number3206
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: