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General NPI Number Information
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NPI Number | 1083602411
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Entity Type | Organization
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Legal Business Name | RENO ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 880 RYLAND STREET
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City | RENO
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State | NV
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Zip | 89502-1603
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Country | US
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Telephone | 775-329-4600
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Fax | 775-334-3911
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Provider Business Mailing Address
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Address Line | PO BOX 842664
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City | LOS ANGELES
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State | CA
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Zip | 90084-2660
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Country | US
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Telephone | 775-329-4600
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Fax | 775-324-4314
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. ERIC OSGARD
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Credential | MD
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Telephone | 775-329-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number | 24558
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License Number State | NV
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