Provider Demographics
NPI:1497771281
Name:HOPE FAMILY PRACTICE
Entity Type:Organization
Organization Name:HOPE FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-777-2210
Mailing Address - Street 1:1995 ERRECART BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89801-8334
Mailing Address - Country:US
Mailing Address - Phone:775-777-2210
Mailing Address - Fax:775-777-1113
Practice Address - Street 1:1995 ERRECART BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8334
Practice Address - Country:US
Practice Address - Phone:775-777-2210
Practice Address - Fax:775-777-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9637261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV=========OtherTAX ID NUMBER
NV=========OtherTAX ID NUMBER
NVV102447Medicare PIN