Provider Demographics
NPI:1225225576
Name:NORTH VALLEY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:NORTH VALLEY MEDICAL ASSOCIATES
Other - Org Name:NORTH VALLEY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER MD
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:PAIVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-329-3484
Mailing Address - Street 1:6542 S MCCARRAN BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6142
Mailing Address - Country:US
Mailing Address - Phone:775-329-3484
Mailing Address - Fax:775-329-5362
Practice Address - Street 1:10555 STEAD BLVD
Practice Address - Street 2:STE 10
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-1871
Practice Address - Country:US
Practice Address - Phone:775-971-3300
Practice Address - Fax:775-971-3307
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH VALLEY MEDICAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9005207Q00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVG79816Medicare UPIN