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General NPI Number Information
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NPI Number | 1912011297
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Entity Type | Organization
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Legal Business Name | SIERRA VISTA SURGERY CENTER, LLC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10463 DOUBLE R BLVD SUITE 200
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City | RENO
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State | NV
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Zip | 89521-8905
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Country | US
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Telephone | 775-851-9400
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Fax |
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Provider Business Mailing Address
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Address Line | 10463 DOUBLE R. BOULEVARD SUITE 200
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City | RENO
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State | NV
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Zip | 89521
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Country | US
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Telephone | 775-851-9400
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JULIE ANNA BUXTON
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Credential |
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Telephone | 775-851-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 4203ASC-1
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License Number State | NV
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