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Carson Tahoe Physician Clinics - Minden #3

Organization Active NPI Family Medicine Physician · Minden, NV

NPI 1023311784 · NPPES record last updated Dec 17, 2010

Key facts

NPI
1023311784
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
12752 (NV)
Legal business name
CARSON TAHOE PHYSICIAN CLINICS - MINDEN #3
Practice address
925 Ironwood Dr
Suite 2105
Minden, NV 89423-5178
Phone
(775) 445-7745
Fax
(775) 782-0073
NPI assigned
Dec 17, 2010
Organization subpart
No

Authorized official

Name
Yolanda Romo
Title
Credentialing Coordinator
Phone
(775) 283-3096

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Carson Tahoe Physician Clinics (14 organizations share this tax ID)

Locations

925 Ironwood Dr
Ste 2105
Minden, NV 89423
Phone (775) 445-7745

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X 12752 NV Yes

Addresses

Primary practice location

925 Ironwood Dr
Suite 2105
Minden, NV 89423-5178

Mailing address

2874 N Carson St
Suite 200
Carson City, NV 89706-0251
Phone (775) 283-3096

Other identifiers

IdentifierTypeStateIssuer
1568596229OtherNPI

Other providers in Minden, NV

All providers in Minden, NV · Family Medicine Physician in Nevada

Sources for this page

Verify at the official NPI Registry.