Provider Demographics
NPI:1235936501
Name:ADVANCED SURGICAL CENTER RENO
Entity type:Organization
Organization Name:ADVANCED SURGICAL CENTER RENO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ASHNAGA
Authorized Official - Middle Name:
Authorized Official - Last Name:YATAWATTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-475-9881
Mailing Address - Street 1:236 W 6TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4553
Mailing Address - Country:US
Mailing Address - Phone:775-475-9881
Mailing Address - Fax:775-870-1110
Practice Address - Street 1:236 W 6TH ST STE 400
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4553
Practice Address - Country:US
Practice Address - Phone:775-475-9881
Practice Address - Fax:775-870-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty