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General NPI Number Information
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NPI Number | 1053103903
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH ALLIANCE
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 999 TAHOE BLVD
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City | INCLINE VILLAGE
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State | NV
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Zip | 89451-9500
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Country | US
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Telephone | 775-329-6300
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Fax | 775-348-3896
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Provider Business Mailing Address
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Address Line | 680 S ROCK BLVD
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City | RENO
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State | NV
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Zip | 89502-4113
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Country | US
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Telephone | 775-329-6300
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Fax | 775-348-3896
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | JENNIFER JEAN WHEELER
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Credential |
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Telephone | 775-329-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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