Healthcare Provider Details

I. General information

NPI: 1639104862
Provider Name (Legal Business Name): BROWN, CALVANESE, CAMERON, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 DOUBLE R BLVD
RENO NV
89521-5931
US

IV. Provider business mailing address

832 WILLOW ST
RENO NV
89502-1304
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-7000
  • Fax:
Mailing address:
  • Phone: 775-324-4040
  • Fax: 775-324-4042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN LAINE
Title or Position: PRESIDENT
Credential: MD
Phone: 775-324-4040