Provider Demographics
NPI:1598740318
Name:SIERRA FAMILY CARE INC
Entity Type:Organization
Organization Name:SIERRA FAMILY CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIELAET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-544-8900
Mailing Address - Street 1:1077 FOURTH STREET STE 2
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150
Mailing Address - Country:US
Mailing Address - Phone:530-543-5652
Mailing Address - Fax:530-541-8723
Practice Address - Street 1:2175 SOUTH AVENUE
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150
Practice Address - Country:US
Practice Address - Phone:530-544-8900
Practice Address - Fax:530-544-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E75085Medicare UPIN
CA00G615610Medicare ID - Type Unspecified