| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KIM TRANDANG | 1396349254 | 2020-11-22 |
| Entity Type | Individual |
| Provider Name | Kim Trandang |
| Practice Office Address | 4855 KIETZKE LN RENO, NV US |
| Practice Office Telephone | 7758291995 |
| Practice Office Fax | 7758292942 |
| Mailing Address | 360 JACKSON SPRINGS DR RENO, NV 895236863 US |
| Business Telephone | 7756365077 |
| Code | License No | State |
|---|---|---|
| 183500000X PRIMARY | 16589 | NV |