Provider Demographics
NPI:1134289002
Name:SOLBERG, CYNTHIA ANN
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ANN
Last Name:SOLBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 KIETZKE LN
Mailing Address - Street 2:STE 103
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2063
Mailing Address - Country:US
Mailing Address - Phone:775-359-2020
Mailing Address - Fax:775-359-2676
Practice Address - Street 1:5420 KIETZKE LN
Practice Address - Street 2:STE 103
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2063
Practice Address - Country:US
Practice Address - Phone:775-359-2020
Practice Address - Fax:775-359-2676
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV468152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV37415Medicare PIN
NVU97592Medicare UPIN
NV4682730001Medicare NSC
NVV105686Medicare PIN