Healthcare Provider Details

I. General information

NPI: 1760468169
Provider Name (Legal Business Name): CAROLINE JOY BARANGAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PRINGLE WAY STE 505
RENO NV
89502-1469
US

IV. Provider business mailing address

850 HARVARD WAY
RENO NV
89502-2055
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-5000
  • Fax: 775-982-3900
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-5496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number10664
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberME113575
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number10664
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: