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10956 Donner Pass Rd Suite 130 Truckee CA 96161-4861 | |
(530) 587-3523 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 10956 Donner Pass Rd, Truckee, California |
Authorized Official Name and Position | Crystal Betts (CFO) |
Authorized Official Contact | 5305826656 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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10956 Donner Pass Rd Suite 130 Truckee CA 96161-4861 Ph: () - | 10956 Donner Pass Rd Suite 130 Truckee CA 96161-4861 Ph: (530) 587-3523 |
NPI Number | 1285174169 |
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Provider Enumeration Date | 02/27/2017 |
Last Update Date | 02/27/2017 |
Medicare PECOS PAC ID | 0446161335 |
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Medicare Enrollment ID | O20171116000925 |
Identifier | Type | State | Issuer |
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1285174169 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 230000151 (California) | Primary |
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