Provider Demographics
NPI:1063068930
Name:TAHOE FOREST HOSPITAL DISTRICT
Entity type:Organization
Organization Name:TAHOE FOREST HOSPITAL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:BETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-582-6656
Mailing Address - Street 1:10121 PINE AVE
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-4835
Mailing Address - Country:US
Mailing Address - Phone:530-587-6011
Mailing Address - Fax:
Practice Address - Street 1:10956 DONNER PASS RD STE 110
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4860
Practice Address - Country:US
Practice Address - Phone:530-581-8864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAHOE FOREST HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty