Provider Demographics
NPI:1780689430
Name:DON B LOUIE
Entity Type:Organization
Organization Name:DON B LOUIE
Other - Org Name:SIERRA PULMONARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-621-2055
Mailing Address - Street 1:6051 ENTERPRISE DR
Mailing Address - Street 2:STE 103
Mailing Address - City:DIAMOND SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95619-9467
Mailing Address - Country:US
Mailing Address - Phone:530-621-2055
Mailing Address - Fax:530-621-2311
Practice Address - Street 1:6051 ENTERPRISE DR
Practice Address - Street 2:STE 103
Practice Address - City:DIAMOND SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95619-9467
Practice Address - Country:US
Practice Address - Phone:530-621-2055
Practice Address - Fax:530-621-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-19
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10052332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME03087FMedicaid
0933730001Medicare ID - Type Unspecified