Organization
SIERRA VISTA MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS VACEK DO (OWNER)
(775) 250-7636
Entity
Organization
Contact information
Practice address
1180 SELMI DR SUITE 201, RENO, NV 89512-4776
(775) 250-7636
Mailing address
1180 SELMI DR SUITE 201, RENO, NV 89512-4776
(775) 250-7636
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1125
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100501342
—
NV
Enumeration date
07/03/2008
Last updated
07/03/2008
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