1023190741 NPI number — DR. SONIA BUDHECHA M.D.

Table of content: DR. SONIA BUDHECHA M.D. (NPI 1023190741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023190741 NPI number — DR. SONIA BUDHECHA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUDHECHA
Provider First Name:
SONIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023190741
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
780 KUENZLI ST
Provider Second Line Business Mailing Address:
202
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89502-0845
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-982-5262
Provider Business Mailing Address Fax Number:
775-982-5496

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 PRINGLE WAY
Provider Second Line Business Practice Location Address:
505
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89502-1464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-982-5000
Provider Business Practice Location Address Fax Number:
775-982-3900
Provider Enumeration Date:
10/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2080P0214X , with the licence number:  8415 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: 8415 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002016645 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".