Provider Type Icon

RICARDO GONZALEZ MD FAMILY PRACTICE PC NPI 1265958862


NPI Information

NPI: 1265958862
Provider Name: RICARDO GONZALEZ MD FAMILY PRACTICE PC

Doing Business As: PEAVINE FAMILY PRACTICE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 29D2139720

Address:
2005 SIERRA HIGHLANDS DR STE 101
RENO, NV
ZIP 89523
Phone: (775) 624-6492
Get Directions

RICARDO GONZALEZ MD FAMILY PRACTICE PC is a family medicine in Reno, NV. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. RICARDO GONZALEZ MD FAMILY PRACTICE PC NPI is 1265958862. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Peavine Family Practice.

The provider's business location address is:

2005 SIERRA HIGHLANDS DR STE 101
RENO, NV
ZIP 89523-301
Phone: (775) 624-6492

The provider's authorized official is Ricardo J. Gonzalez .
The authorized official title is Owner and has the following contact phone number (775) 624-6492.

The CLIA number assigned to this NPI record is 29D2139720 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/16/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral Practice10279NEVADANo
2207Q00000XFamily Medicine10279NEVADAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
113216011297MEDICAIDNEVADA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.