| Truckee Tahoe Medical Group Inc | |
|
10956 Donner Pass Rd Truckee CA 96161-4861 | |
| (530) 581-8864 | |
| Not Available |
| Full Name | Truckee Tahoe Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 10956 Donner Pass Rd, Truckee, California |
| Authorized Official Name and Position | Niki Holoday (MANAGER) |
| Authorized Official Contact | 5305818864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Truckee Tahoe Medical Group Inc Po Box 68 Truckee CA 96160-0068 Ph: (530) 581-8864 | Truckee Tahoe Medical Group Inc 10956 Donner Pass Rd Truckee CA 96161-4861 Ph: (530) 581-8864 |
| NPI Number | 1821081696 |
|---|---|
| Provider Enumeration Date | 08/26/2005 |
| Last Update Date | 05/16/2014 |
| Medicare PECOS PAC ID | 3779570395 |
|---|---|
| Medicare Enrollment ID | O20040427000651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821081696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeanne Plumb |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215961354 PECOS PAC ID: 6901862341 Enrollment ID: I20041207000697 |
| Provider Name | Reini Anna Jensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295881787 PECOS PAC ID: 4688629967 Enrollment ID: I20050318000915 |
| Provider Name | Paul K Krause |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184770653 PECOS PAC ID: 9032157615 Enrollment ID: I20081009000113 |
| Provider Name | Gina Barta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982750451 PECOS PAC ID: 0941248520 Enrollment ID: I20081013000095 |
| Provider Name | Richard B Ganong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932255403 PECOS PAC ID: 8123066701 Enrollment ID: I20081204000580 |
| Provider Name | Gregg M Paul |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306992896 PECOS PAC ID: 6002962453 Enrollment ID: I20090925000530 |
| Provider Name | Scott Samelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356583264 PECOS PAC ID: 5193954311 Enrollment ID: I20140211001862 |
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