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General NPI Number Information
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NPI Number | 1114033529
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Entity Type | Organization
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Legal Business Name | BARTON HEALTHCARE SYSTEM
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 1111 SIERRA AT TAHOE RD
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City | TWIN BRIDGES
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State | CA
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Zip | 95735-9505
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Country | US
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Telephone | 530-659-7434
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Fax | 530-659-7463
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Provider Business Mailing Address
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Address Line | 2170 SOUTH AVE
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-7026
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Country | US
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Telephone | 530-543-5659
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Fax | 530-541-8723
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Authorized Official
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Title or Position | CEO
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Name | MR. CLINTON PURANCE
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Credential | MD
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Telephone | 530-541-3420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | CA
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