Healthcare Provider Details

I. General information

NPI: 1730350398
Provider Name (Legal Business Name): ROBERT J. ROSENQUIST, CHTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2008
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W PLUMB LN SUITE 2A
RENO NV
89509-3467
US

IV. Provider business mailing address

540 W PLUMB LN SUITE 2A
RENO NV
89509-3467
US

V. Phone/Fax

Practice location:
  • Phone: 775-348-1811
  • Fax: 775-348-7738
Mailing address:
  • Phone: 775-348-1811
  • Fax: 775-348-7738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number3981
License Number StateNV

VIII. Authorized Official

Name: DR. ROBERT J. ROSENQUIST
Title or Position: PRESIDENT
Credential: M.D.
Phone: 775-348-1811