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Organization
TRUCKEE TAHOE MEDICAL GROUP
Active
Organization
TRUCKEE TAHOE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKI HOLODAY (MANAGER)
(530) 581-8864
Entity
Organization
Contact information
Practice address
925 N LAKE BLVD, TAHOE CITY, CA 96145
(530) 581-8864
Mailing address
10115 W RIVER ST, TRUCKEE, CA 96161-0324
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A68375
CA
Other
Enumeration date
06/15/2010
Last updated
06/15/2010
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