Healthcare Provider Details

I. General information

NPI: 1811013386
Provider Name (Legal Business Name): BENJAMIN TIM PENCE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1495 MILL ST
RENO NV
89502
US

IV. Provider business mailing address

1155 MILL ST MS M-14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-5000
  • Fax: 775-982-8001
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License NumberDO2448
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberDO2448
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: