Provider Demographics
NPI:1285936252
Name:S ALTINSAN MD PC
Entity type:Organization
Organization Name:S ALTINSAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:SAIDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALTINSAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-846-7077
Mailing Address - Street 1:PO BOX 20823
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89515-0823
Mailing Address - Country:US
Mailing Address - Phone:775-846-7077
Mailing Address - Fax:775-827-4799
Practice Address - Street 1:3732 LAKESIDE DR
Practice Address - Street 2:#200
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5278
Practice Address - Country:US
Practice Address - Phone:775-846-7077
Practice Address - Fax:775-827-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-24
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV72652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVMD7265Medicare PIN
NVF98811Medicare UPIN