Healthcare Provider Details
I. General information
NPI: 1669821260
Provider Name (Legal Business Name): ELLIA CIAMMAICHELLA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/06/2016
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5150 MAE ANNE AVE STE 405
RENO NV
89523-1859
US
IV. Provider business mailing address
5150 MAE ANNE AVE STE 405
RENO NV
89523-1859
US
V. Phone/Fax
- Phone: 408-857-3395
- Fax:
- Phone: 775-902-6917
- Fax: 775-490-0151
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | MED-PHYS-COM-LIC-117 |
| License Number State | MT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | O-1775 |
| License Number State | ID |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | OP61074874 |
| License Number State | WA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | 200818 |
| License Number State | AK |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P0301X |
| Taxonomy | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | DO2977 |
| License Number State | NV |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P0301X |
| Taxonomy | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | 200818 |
| License Number State | AK |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P0004X |
| Taxonomy | Spinal Cord Injury Medicine Physician |
| License Number | DO2977 |
| License Number State | NV |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | 11273456-1204 |
| License Number State | UT |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P0301X |
| Taxonomy | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | O-1775 |
| License Number State | ID |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | CDR.0004654 |
| License Number State | CO |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | 22251 |
| License Number State | CA |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | DO2977 |
| License Number State | NV |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P0301X |
| Taxonomy | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | 11273456-1204 |
| License Number State | UT |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P0301X |
| Taxonomy | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | OP61074874 |
| License Number State | WA |
| # 15 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | 02009025A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
