Organization
LAKE TAHOE ORTHOPAEDIC INSTITUTE
Active
Other names
DME - Third Street
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN M BANNAR MD (PRESIDENT)
(530) 541-3100
Entity
Organization
Contact information
Practice address
1139 3RD ST, SOUTH LAKE TAHOE, CA 96150-3465
(530) 541-3100
(530) 541-3016
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5659
(530) 541-8723
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/03/2009
Last updated
09/19/2012
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