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General NPI Number Information
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NPI Number | 1487954632
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Entity Type | Organization
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Legal Business Name | SIERRA HEALTHCARE LLC
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 10/21/2010
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Provider Practice Location Address
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Address Line | 9436 DOUBLE R BLVD A
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City | RENO
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State | NV
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Zip | 89521-2998
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Country | US
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Telephone | 775-284-0911
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Fax | 775-851-1482
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Provider Business Mailing Address
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Address Line | 9436 DOUBLE R BLVD A
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City | RENO
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State | NV
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Zip | 89521-2998
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Country | US
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Telephone | 775-284-0911
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Fax | 775-851-1482
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Authorized Official
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Title or Position | PHYSICIAN/CEO
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Name | BORIS VOLSHTEYN
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Credential | MD
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Telephone | 775-284-0911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 101395
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License Number State | NV
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