Provider Demographics
NPI:1609822477
Name:BERTRANDO, ROBERT BERTRAND (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BERTRAND
Last Name:BERTRANDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BERTRAND
Other - Middle Name:ROBERT
Other - Last Name:BERTRANDO
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12625 ROSEVIEW LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8641
Mailing Address - Country:US
Mailing Address - Phone:775-851-1266
Mailing Address - Fax:
Practice Address - Street 1:118 E HASKELL ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3247
Practice Address - Country:US
Practice Address - Phone:775-623-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5202207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C95790Medicare UPIN