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Organization
DEANE A STITES MD INC
Active
Organization
DEANE A STITES MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANE A STITES (PRESIDENT)
(530) 587-7461
Entity
Organization
Contact information
Practice address
10051 LAKE AVE, STE 3, TRUCKEE, CA 96161-0445
(530) 587-7461
(530) 587-1149
Mailing address
10051 LAKE AVE, STE 3, TRUCKEE, CA 96161-0445
(530) 587-7461
(530) 587-1149
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G31474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G374740
—
CA
01
—
200018214
RAILROAD MEDICARE
CA
Enumeration date
11/19/2008
Last updated
03/04/2010
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