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General NPI Number Information
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NPI Number | 1548816895
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Entity Type | Organization
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Legal Business Name | RENO TAHOE ANESTHESIA WEAVER PC
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 625 INNOVATION DR
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City | RENO
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State | NV
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Zip | 89511-2215
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Country | US
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Telephone | 775-799-7320
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 840559
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City | LOS ANGELES
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State | CA
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Zip | 90084-0559
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Country | US
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Telephone | 775-507-3390
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GAVIN HARVEY HARTMAN
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Credential | MD
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Telephone | 775-770-3209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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