TAHOE CARSON VALLEY MEDICAL GROUP INC NPI 1508865528

NPI Information

TAHOE CARSON VALLEY MEDICAL GROUP INC is a family medicine in South Lake Tahoe, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. TAHOE CARSON VALLEY MEDICAL GROUP INC NPI is 1508865528. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2170 SOUTH AVE
SOUTH LAKE TAHOE, CA
ZIP 96150
Phone: (530) 541-3420
Fax: (530) 541-8723

The provider's authorized official is David Young .
The authorized official title is President and has the following contact phone number (775) 589-8916.

The CLIA number assigned to this NPI record is 05D0957667 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/20/2005 and was last updated on 6/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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