Provider Demographics
NPI:1316059694
Name:GARCIA, HO, KLOSE AND MCGAW MEDICAL GROUP LT
Entity type:Organization
Organization Name:GARCIA, HO, KLOSE AND MCGAW MEDICAL GROUP LT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:MCGAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-688-5881
Mailing Address - Street 1:PO BOX 30053
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89520-3053
Mailing Address - Country:US
Mailing Address - Phone:775-688-5615
Mailing Address - Fax:775-688-5626
Practice Address - Street 1:1500 EAST SECOND ST.
Practice Address - Street 2:SUITE 408
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-688-5881
Practice Address - Fax:775-688-5626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVWCHJAMedicare PIN