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Individual

JUAN L MACIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1155 MILL ST, RENO, NV 89502-1576
(775) 258-1970
(775) 258-1966
Mailing address
1155 MILL ST # M14, RENO, NV 89502-1576
(775) 982-5262
(775) 258-1966

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
12984945-1205
UT
207L00000X
Anesthesiology Physician
Primary
27737
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16568470
CAQH ID
NV
01
27737
MD ID
NV
Enumeration date
03/29/2021
Last updated
07/16/2025
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