Provider Demographics
NPI:1578516530
Name:PLANNED PARENTHOOD MAR MONTE INC
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD MAR MONTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTSIFF
Authorized Official - Suffix:
Authorized Official - Credentials:MHA, CMA
Authorized Official - Phone:408-795-3707
Mailing Address - Street 1:4385 NEIL RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-5103
Mailing Address - Country:US
Mailing Address - Phone:775-829-2211
Mailing Address - Fax:775-829-4391
Practice Address - Street 1:4385 NEIL RD
Practice Address - Street 2:SUITE 105
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-5103
Practice Address - Country:US
Practice Address - Phone:775-829-2211
Practice Address - Fax:775-829-4391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV001716910Medicaid
NV35954Medicare PIN