Provider Demographics
NPI:1710075437
Name:SIERRA NEVADA ENT ASSOCIATES LTD
Entity Type:Organization
Organization Name:SIERRA NEVADA ENT ASSOCIATES LTD
Other - Org Name:SIERRA NEVADA ENT ASSOCIATES LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-283-3341
Mailing Address - Street 1:1493 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4635
Mailing Address - Country:US
Mailing Address - Phone:775-883-7666
Mailing Address - Fax:775-883-0115
Practice Address - Street 1:1493 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4635
Practice Address - Country:US
Practice Address - Phone:775-883-7666
Practice Address - Fax:775-883-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV32615Medicare ID - Type Unspecified
CAZZZ20749ZMedicare ID - Type Unspecified
NVV103650Medicare PIN