Provider Demographics
NPI:1720049620
Name:FOLEY, JOHN V (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:V
Last Name:FOLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2349
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96160-2349
Mailing Address - Country:US
Mailing Address - Phone:530-535-5065
Mailing Address - Fax:530-536-5069
Practice Address - Street 1:10956 DONNER PASS RD
Practice Address - Street 2:SUITE310
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4861
Practice Address - Country:US
Practice Address - Phone:530-536-5065
Practice Address - Fax:530-536-5069
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76285207X00000X
NVNV7929207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G762850OtherMEDI-CAL
200044843OtherRAILROAD MEDICARE
CA00G762850Medicaid
CA1153510001Medicare NSC
CA00G762850OtherMEDI-CAL