Healthcare Provider Details

I. General information

NPI: 1316059694
Provider Name (Legal Business Name): GARCIA, HO, KLOSE AND MCGAW MEDICAL GROUP LT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 12/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 EAST SECOND ST. SUITE 408
RENO NV
89502
US

IV. Provider business mailing address

PO BOX 30053
RENO NV
89520-3053
US

V. Phone/Fax

Practice location:
  • Phone: 775-688-5881
  • Fax: 775-688-5626
Mailing address:
  • Phone: 775-688-5615
  • Fax: 775-688-5626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRENCE GORDON MCGAW
Title or Position: PRESIDENT
Credential: M.D.
Phone: 775-688-5881