# MOUNTAIN MEADOWS MEDICAL GROUP OF CALIFORNIA, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tahoe Women's Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497936694
- **Authorized official:** DR. KRIS F KOBALTER MD (VICE PRESIDENT)
- **Authorized official phone:** (530) 543-5710

## Contact information

- **Practice address:** 973 MICA DR STE 200, CARSON CITY, NV 89705-7258
- **Practice address phone:** (775) 267-6700
- **Practice address fax:** (775) 267-6609
- **Mailing address:** 1067 4TH ST, SOUTH LAKE TAHOE, CA 96150-3459
- **Mailing address phone:** (530) 543-5710
- **Mailing address fax:** (530) 542-1455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NV | Yes |

## Other

- **Enumeration date:** 11/16/2007
- **Last updated:** 09/19/2012