Healthcare Provider Details

I. General information

NPI: 1720541147
Provider Name (Legal Business Name): GREGGORY GAHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 RYLAND ST
RENO NV
89502-1605
US

IV. Provider business mailing address

655 N ALVERNON WAY STE 204
TUCSON AZ
85711-1825
US

V. Phone/Fax

Practice location:
  • Phone: 757-329-0286
  • Fax:
Mailing address:
  • Phone: 520-626-2010
  • Fax: 520-626-2042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number23736
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: