Healthcare Provider Details

I. General information

NPI: 1972276947
Provider Name (Legal Business Name): SANTHI NIRMALA SANJANA NARASIMHADEVARA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10085 DOUBLE R BLVD STE 310
RENO NV
89521-4832
US

IV. Provider business mailing address

1155 MILL ST # M-14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-7260
  • Fax: 775-982-7268
Mailing address:
  • Phone: 775-982-7260
  • Fax: 775-982-7268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number28076
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number195069
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: