# SIERRA NEVADA MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730153826
- **Authorized official:** DAVID HOWARD JOHNSON MD (PRESIDENT)
- **Authorized official phone:** (775) 782-8186

## Contact information

- **Practice address:** 1624 LIBRARY LANE, SUITE B, MINDEN, NV 89423
- **Practice address phone:** (775) 782-8186
- **Practice address fax:** (775) 782-4683
- **Mailing address:** 1077 FOURTH STREET, SUITE 12, SOUTH LAKE TAHOE, CA 96150
- **Mailing address phone:** (530) 543-5640
- **Mailing address fax:** (530) 541-8723

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NV | Yes |

## Other

- **Enumeration date:** 02/15/2006
- **Last updated:** 07/21/2022