Healthcare Provider Details

I. General information

NPI: 1053485813
Provider Name (Legal Business Name): PATRICK LEE CLASS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 KIRMAN AVE STE LL-1
RENO NV
89502-1346
US

IV. Provider business mailing address

850 HARVARD WAY
RENO NV
89502-2055
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-2828
  • Fax: 775-982-2834
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-5946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License Number4682
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number4682
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: