Cristobal E Cordova, DPT – Specialist in Reno, NV

Key facts

NPI: 1689009284
Entity type: Individual (NPI type 1)
Primary specialty: Specialist 174400000X
License: 2730 (NV)
Practice address: 15 McCabe Dr
Suite 101
Reno, NV 89511-5924
Phone: (775) 788-5599
Fax: (775) 788-5598
NPI assigned: Sep 13, 2013
Sex: Male
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Specialist	174400000X	2730	NV	Yes

Addresses

Primary practice location

15 McCabe Dr
Suite 101
Reno, NV 89511-5924

Mailing address

15 McCabe Dr
Suite 101
Reno, NV 89511-5924
Phone (775) 788-5599

Other identifiers

Identifier	Type	State	Issuer
2730	Other	NV	LICENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 13, 2013.

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1689009284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 MCCABE DR",
            "address_2": "SUITE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895115924",
            "telephone_number": "775-788-5599",
            "fax_number": "775-788-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MCCABE DR",
            "address_2": "SUITE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895115924",
            "telephone_number": "775-788-5599",
            "fax_number": "775-788-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "CRISTOBAL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "2730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2730",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

All providers in Reno, NV · Specialist in Nevada

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.