Healthcare Provider Details

I. General information

NPI: 1720080120
Provider Name (Legal Business Name): LAURI KALANGES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 NEWLANDS CIR
RENO NV
89509-1322
US

IV. Provider business mailing address

PO BOX 19665
RENO NV
89511-2179
US

V. Phone/Fax

Practice location:
  • Phone: 775-843-6665
  • Fax:
Mailing address:
  • Phone: 775-843-6665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD6645
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: