Healthcare Provider Details

I. General information

NPI: 1447132816
Provider Name (Legal Business Name): RAAS PEDIATRICS PATEL SINGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5437 KIETZKE LN
RENO NV
89511-1088
US

IV. Provider business mailing address

5437 KIETZKE LN
RENO NV
89511-1088
US

V. Phone/Fax

Practice location:
  • Phone: 775-784-3319
  • Fax:
Mailing address:
  • Phone: 775-784-3319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number
License Number State

VIII. Authorized Official

Name: MELE PULOKA
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 775-784-3319