Healthcare Provider Details

I. General information

NPI: 1225225576
Provider Name (Legal Business Name): NORTH VALLEY MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10555 STEAD BLVD STE 10
RENO NV
89506-1871
US

IV. Provider business mailing address

6542 S MCCARRAN BLVD STE B
RENO NV
89509-6142
US

V. Phone/Fax

Practice location:
  • Phone: 775-971-3300
  • Fax: 775-971-3307
Mailing address:
  • Phone: 775-329-3484
  • Fax: 775-329-5362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9005
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number9005
License Number StateNV

VIII. Authorized Official

Name: ROSE E PAIVA
Title or Position: OWNER MD
Credential: MD
Phone: 775-329-3484