# TAHOE ORTHOPEDICS AND SPORTS MEDICINE, INC

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

## Provider details

- **NPI number:** 1831483767
- **Authorized official:** DR. ROBERT E. RUPP MD (PRESIDENT)
- **Authorized official phone:** (530) 541-3100

## Contact information

- **Practice address:** 1139 3RD ST, SOUTH LAKE TAHOE, CA 96150-3465
- **Practice address phone:** (530) 541-3100
- **Mailing address:** 1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
- **Mailing address phone:** (530) 543-5659
- **Mailing address fax:** (530) 541-8723

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G82106 | CA | Yes |

## Other

- **Enumeration date:** 06/08/2011
- **Last updated:** 04/17/2020