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General NPI Number Information
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NPI Number | 1811013386
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Entity Type | Individual
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Provider Name | BENJAMIN TIM PENCE D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 1495 MILL ST
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City | RENO
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State | NV
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Zip | 89502
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Country | US
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Telephone | 775-982-5000
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Fax | 775-982-8001
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Provider Business Mailing Address
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Address Line | 1155 MILL ST # MCM14
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City | RENO
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State | NV
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Zip | 89502-1576
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Country | US
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Telephone | 775-982-5262
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Fax | 775-982-5496
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | DO2448
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | DO2448
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number | 20A10836
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License Number State | CA
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