Basic Information
| Provider Information | |||||||||
| NPI: | 1548208283 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | AKHTAR ALBRIGHT CHU DIXON NACHTSHEIM SIEFFERT & STUMPF MDS PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | GENERAL AND VASCULAR ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 E 2ND STREET | ||||||||
| Address2: | #206 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757897000 | ||||||||
| FaxNumber: | 7757897040 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 E 2ND STREET #206 | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757897000 | ||||||||
| FaxNumber: | 7757897040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 03/23/2016 | ||||||||
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| AuthorizedOfficialLastName: | SILVA | ||||||||
| AuthorizedOfficialFirstName: | CHRISTIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7757897000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 208G00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2086S0129X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | XGG007210 | 05 | CA | MEDICAID | 100505595 | 05 | NV | MEDICAID |