Provider Demographics
NPI:1346483369
Name:CAUGHLIN RANCH FETAL IMAGING CENTER
Entity Type:Organization
Organization Name:CAUGHLIN RANCH FETAL IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:775-828-7525
Mailing Address - Street 1:6502 S MCCARRAN BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6161
Mailing Address - Country:US
Mailing Address - Phone:775-828-7525
Mailing Address - Fax:775-825-5073
Practice Address - Street 1:6502 S MCCARRAN BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6161
Practice Address - Country:US
Practice Address - Phone:775-828-7525
Practice Address - Fax:775-825-5073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty