Tahoe Carson Valley Medical Group, Inc.
Organization Active NPI Durable Medical Equipment & Medical Supplies · Stateline, NV
NPI 1124334776 · NPPES record last updated Sep 19, 2012
Key facts
- NPI
- 1124334776
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- TAHOE CARSON VALLEY MEDICAL GROUP, INC.
- Practice address
- 155 Hwy 50
Stateline, NV 89449-9800 - Phone
- (775) 589-8900
- Fax
- (775) 588-7110
- NPI assigned
- Aug 20, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Gregory Walter Bergner, MD
- Title
- President
- Phone
- (775) 589-8900
Practitioners 9
-
Jay Chung, MD
-
Eric J Ewald Jr., MD
-
Cathey R Knight, FNP
-
Tracy Regina Protell, M.D.
-
Sonia N Rupp, MD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
155 Hwy 50
Stateline, NV 89449-9800
Mailing address
1111 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207
Phone (530) 543-5659
Other names
- DME-Stateline Medical Center
Other providers in Stateline, NV
- Martin Ernst Salm
- State of Nevada
- Steven L Kline OD a Professional Corporation
- Natalie Stevenson
- Maureen Sullivan
- Andrew Ho Keung Tang
- Lucas Nathan Vine
- Lisa A Weigle
- Warren Tilden Withers
- Ahmed Zarrugh
All providers in Stateline, NV · Durable Medical Equipment & Medical Supplies in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.