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General NPI Number Information
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NPI Number | 1295645703
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Entity Type | Organization
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Legal Business Name | MY VIVA MEDICAL PA
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 940 LITTLE STAR DR
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City | RENO
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State | NV
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Zip | 89511-7310
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Country | US
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Telephone | 775-564-2524
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Fax |
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Provider Business Mailing Address
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Address Line | 940 LITTLE STAR DR
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City | RENO
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State | NV
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Zip | 89511-7310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YAZEN JOUDEH
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Credential | MD
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Telephone | 775-564-2524
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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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