Healthcare Provider Details

I. General information

NPI: 1578025565
Provider Name (Legal Business Name): KIMEN SINGH BALHOTRA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E 2ND ST STE 203
RENO NV
89502-1196
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 775-982-4455
  • Fax: 775-982-8060
Mailing address:
  • Phone: 775-982-4455
  • Fax: 775-982-8060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number30156
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number30156
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberU3150
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: