Healthcare Provider Details

I. General information

NPI: 1104042522
Provider Name (Legal Business Name): TRUCKEE SPINAL DIAGNOSTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12219 BUSINESS PARK DR #10
TRUCKEE CA
96161-3323
US

IV. Provider business mailing address

12219 BUSINESS PARK DR #10
TRUCKEE CA
96161-3323
US

V. Phone/Fax

Practice location:
  • Phone: 530-550-7175
  • Fax:
Mailing address:
  • Phone: 530-550-7175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: DAVID L SALINGER
Title or Position: OWNER
Credential: MD
Phone: 408-370-9080