Healthcare Provider Details

I. General information

NPI: 1801277678
Provider Name (Legal Business Name): JOSHUA ROBERT PFENT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10956 DONNER PASS RD FL 23
TRUCKEE CA
96161-4861
US

IV. Provider business mailing address

10956 DONNER PASS RD FL 23
TRUCKEE CA
96161-4861
US

V. Phone/Fax

Practice location:
  • Phone: 530-587-6011
  • Fax:
Mailing address:
  • Phone: 530-587-6011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA156806
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: