Provider Demographics
NPI:1952082612
Name:UROLOGY NEVADA LTD. DR. GHOLDOIAN
Entity Type:Organization
Organization Name:UROLOGY NEVADA LTD. DR. GHOLDOIAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GABELICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-322-7811
Mailing Address - Street 1:5560 KIETZKE LN BLDG A
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3019
Mailing Address - Country:US
Mailing Address - Phone:775-322-7811
Mailing Address - Fax:
Practice Address - Street 1:10745 DOUBLE R BLVD # 13
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8979
Practice Address - Country:US
Practice Address - Phone:775-322-7811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UROLOGY NEVADA LTD. DR. GHOLDOIAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty