Provider Demographics
NPI:1598918302
Name:GERARDO D RODRIGUEZ-GOMEZ, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GERARDO D RODRIGUEZ-GOMEZ, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARDO
Authorized Official - Middle Name:D
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-322-7272
Mailing Address - Street 1:1190 RYLAND ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1702
Mailing Address - Country:US
Mailing Address - Phone:775-322-7272
Mailing Address - Fax:775-322-4789
Practice Address - Street 1:1190 RYLAND ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1702
Practice Address - Country:US
Practice Address - Phone:775-322-7272
Practice Address - Fax:775-322-4789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV60802084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty