Individual
JONATHAN E LAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 MILL ST, RENO, NV 89502-1576
(775) 982-4100
Mailing address
832 WILLOW ST, RENO, NV 89502-1304
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
6271
NV
207P00000X
Emergency Medicine Physician
G63676
CA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
6271
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201660013
—
NV
01
—
930013312
RAILROAD
NV
01
—
CC3690
BC/BS
NV
Enumeration date
03/21/2006
Last updated
10/28/2020
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