Healthcare Provider Details
I. General information
NPI: 1346879467
Provider Name (Legal Business Name): RACHEL KARLEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/02/2020
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1525 LOS ALTOS PKWY
SPARKS NV
89436-6692
US
IV. Provider business mailing address
1155 MILL ST # MS 14
RENO NV
89502-1576
US
V. Phone/Fax
- Phone: 775-982-5437
- Fax: 775-982-3900
- Phone: 775-982-5262
- Fax: 775-982-5496
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | DO3415 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: