Provider Demographics
NPI:1144617507
Name:DESFOR, REBECCA J (DO)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:J
Last Name:DESFOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:850 HARVARD WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-2055
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:85 KIRMAN AVE STE LL-1
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1346
Practice Address - Country:US
Practice Address - Phone:775-982-2828
Practice Address - Fax:775-982-2834
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2019-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVDO2415207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine