Organization
SIERRA NEVADA MEDICAL IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT SILK MD (AUTHORIZED OFFICIAL)
(559) 297-0300
Entity
Organization
Contact information
Practice address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150
(559) 297-0300
(530) 542-9550
Mailing address
PO BOX 19879, RENO, NV 89511-2533
(888) 480-6640
(775) 852-6902
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100507836
—
NV
05
—
100507852
—
NV
01
—
CA7623
RR MEDICARE
NV
01
—
CA7624
RR MEDICARE
CA
05
—
GR0099310
—
CA
Enumeration date
01/10/2006
Last updated
09/17/2020
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