Individual
DR. LARS DOUGLAS ENSIGN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
(530) 541-3420
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5639
(530) 541-8723
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
9855
NV
207P00000X
Emergency Medicine Physician
Primary
A75593
CA
Other
Enumeration date
07/12/2005
Last updated
03/17/2018
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