Healthcare Provider Details

I. General information

NPI: 1538182613
Provider Name (Legal Business Name): ANITA KEDIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E 2ND ST STE 400
RENO NV
89502-1198
US

IV. Provider business mailing address

1155 MILL ST # MSM14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-2400
  • Fax: 775-982-2410
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC203809
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number12679
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number12679
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: