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Organization

TAHOE ORTHOPEDICS & SPORTS MEDICINE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KYLE E SWANSON MD (PRESIDENT)
(530) 543-5554
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
CA
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
06/12/2023
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