EL DORADO COUNTY CCS NPI 1730212937

NPI Information

  • NPI: 1730212937
  • Provider Name: EL DORADO COUNTY CCS
  • Classification: Clinic/Center - 261QR0400X
  • Specialization: Rehabilitation
  • Entity Type: Organization
  • Doing Business As: SOUTH LAKE TAHOE MTU
  • Address: 1100 LYONS AVE
    SOUTH LAKE TAHOE, CA
    ZIP 96150
  • Phone: (530) 543-2313

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NPI Details

EL DORADO COUNTY CCS is a rehabilitation clinic center in South Lake Tahoe, CA. EL DORADO COUNTY CCS NPI is 1730212937. The provider is registered as an organization entity type.
The provider Is Doing Business As South Lake Tahoe Mtu.

The provider's business location address is:

1100 LYONS AVE
SOUTH LAKE TAHOE, CA
ZIP 96150-252
Phone: (530) 543-2313
Fax: (530) 543-2275

The provider's authorized official is Gayle Erbe-hamlin .
The authorized official title is PUBLIC HEALTH DIRECTORDirector and has the following contact phone number (530) 621-6191.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 8/22/2020.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0400XClinic/CenterRehabilitationYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CCS00108FMEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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