Healthcare Provider Details

I. General information

NPI: 1477508018
Provider Name (Legal Business Name): DAVID C LEPPLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 09/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5590 KIETZKE LN
RENO NV
89511-3019
US

IV. Provider business mailing address

5590 KIETZKE LN
RENO NV
89511-3019
US

V. Phone/Fax

Practice location:
  • Phone: 775-323-2080
  • Fax: 775-325-2334
Mailing address:
  • Phone: 775-323-2080
  • Fax: 775-325-2334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number11236
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: