# TAHOE ORTHOPEDICS & SPORTS MEDICINE, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1902131287
- **Authorized official:** DR. KYLE E SWANSON MD (PRESIDENT)
- **Authorized official phone:** (530) 543-5554

## Contact information

- **Practice address:** 2170B SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
- **Practice address phone:** (530) 543-5554
- **Practice address fax:** (530) 541-3016
- **Mailing address:** 2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
- **Mailing address phone:** (530) 543-5659
- **Mailing address fax:** (530) 541-8723

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | CA | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | CA | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | CA | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | CA | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | CA | — |
| 225X00000X | Occupational Therapist | — | CA | — |
| 363A00000X | Physician Assistant | — | CA | — |

## Other

- **Enumeration date:** 10/05/2009
- **Last updated:** 07/29/2026