Healthcare Provider Details

I. General information

NPI: 1255838454
Provider Name (Legal Business Name): MEARI TAGUCHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E 2ND ST STE 300
RENO NV
89502-1198
US

IV. Provider business mailing address

1155 MILL ST # M14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-6270
  • Fax: 775-982-6271
Mailing address:
  • Phone: 775-982-6270
  • Fax: 775-982-6271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License Number24038
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301506405
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number24038
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: