MEDICARE: DR. WES JAMES IRWIN MD MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	44785-020	WI
2	207L00000X	Anesthesiology Physician	A83047	CA
3	207L00000X	Anesthesiology Physician	10912	NV

General Provider Information

NPI Number	:	1538166715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WES JAMES IRWIN MD MS

Provider Business Mailing Address
First Line	:	710 LASSEN DR
Second Line	:
City	:	SOUTH LAKE TAHOE
State	:	CA
Zip	:	96150-4446
Country	:	US
Telephone Number	:	530-545-1175
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E 2ND ST STE 1230
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89501-1587
Country	:	US
Telephone Number	:	530-545-1175
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2005
Last Update Date	:	02/06/2025

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