Provider Demographics
NPI:1265573828
Name:H MALIN PRUPAS MD
Entity type:Organization
Organization Name:H MALIN PRUPAS MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:H.
Authorized Official - Middle Name:MALIN
Authorized Official - Last Name:PRUPAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-786-9100
Mailing Address - Street 1:80 GIROUX STREET
Mailing Address - Street 2:#101
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502
Mailing Address - Country:US
Mailing Address - Phone:775-786-9100
Mailing Address - Fax:775-786-9113
Practice Address - Street 1:80 GIROUX STREET
Practice Address - Street 2:#101
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-786-9100
Practice Address - Fax:775-786-9113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV38490Medicare PIN