Organization
NORTH TAHOE ORTHOPEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA ANN SMALL (OFFICE MANAGER)
(530) 587-7461
Entity
Organization
Contact information
Practice address
10051 LAKE AVE, SUITE 3, TRUCKEE, CA 96161-0445
(530) 587-7461
(530) 587-1149
Mailing address
10051 LAKE AVE, SUITE 3, TRUCKEE, CA 96161-0445
(530) 587-7461
(530) 587-1149
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A81163
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6530720001
MEDICARE DMEPOS PTAN
CA
01
—
EM658A
MEDICARE PTAN
CA
Enumeration date
12/08/2010
Last updated
06/18/2015
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