| Organization Name: | PIONEER URGENT AND FAMILY MEDICAL CLINIC |
| NPI Number: | 1043499130 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LOUIS BERGERON (PRESIDENT/OWNER) |
| Mailing Address: | 160 12th St Elko |
| State: | NV US |
| Postal Code: | 898014002 |
| Phone Number: | 7757382034 |
| Fax Number: | 7757383241 |
| NPI Enumeration Date: | 10/25/2007 |
| NPI Last Update Date: | 01/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | 705372 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |