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General NPI Number Information
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NPI Number | 1538689583
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Entity Type | Organization
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Legal Business Name | TAHOE FOREST HOSPITAL DISTRICT
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 12/15/2022
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Provider Practice Location Address
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Address Line | 10175 LEVONE AVE
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City | TRUCKEE
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State | CA
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Zip | 96161-4821
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Country | US
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Telephone | 530-587-1041
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 759
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City | TRUCKEE
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State | CA
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Zip | 96160-0759
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CRYSTAL BETTS
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Credential |
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Telephone | 530-582-6656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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