Provider Demographics
NPI:1396774162
Name:RENO ONCOLOGY CONSULTANTS LTD
Entity type:Organization
Organization Name:RENO ONCOLOGY CONSULTANTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:CONRATH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-329-0222
Mailing Address - Street 1:PO BOX 748267
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-8267
Mailing Address - Country:US
Mailing Address - Phone:775-329-0222
Mailing Address - Fax:775-329-3010
Practice Address - Street 1:6130 PLUMAS ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-6060
Practice Address - Country:US
Practice Address - Phone:775-329-0222
Practice Address - Fax:775-329-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3747174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWCHGGMedicare PIN