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General NPI Number Information
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NPI Number | 1689775595
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Entity Type | Organization
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Legal Business Name | DIGESTIVE HEALTH ASSOCIATES
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 05/12/2010
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Provider Practice Location Address
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Address Line | 655 SIERRA ROSE DR
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City | RENO
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State | NV
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Zip | 89511-2060
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Country | US
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Telephone | 775-829-7600
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Fax | 775-829-3752
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Provider Business Mailing Address
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Address Line | 5250 KIETZKE LN
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City | RENO
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State | NV
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Zip | 89511-2037
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Country | US
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Telephone | 775-829-8855
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Fax | 775-829-3752
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MS. JOAN JOUAN
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Credential |
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Telephone | 775-829-8855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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