Provider Demographics
NPI:1588673149
Name:MICHAEL M SALAS MD INC
Entity Type:Organization
Organization Name:MICHAEL M SALAS MD INC
Other - Org Name:TAHOE SPINE AND PAIN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OF COMPANY
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SALAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-832-8288
Mailing Address - Street 1:889 ALDER AVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:INCLINE VILLAGE
Mailing Address - State:NV
Mailing Address - Zip Code:89451-8203
Mailing Address - Country:US
Mailing Address - Phone:775-832-8288
Mailing Address - Fax:775-831-7024
Practice Address - Street 1:889 ALDER AVE
Practice Address - Street 2:SUITE 303
Practice Address - City:INCLINE VILLAGE
Practice Address - State:NV
Practice Address - Zip Code:89451-8203
Practice Address - Country:US
Practice Address - Phone:775-832-8288
Practice Address - Fax:775-831-7024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV208100000X
NV11341208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAW285Medicare PIN
NVV101417Medicare PIN