Provider Demographics
NPI:1811031461
Name:STEVEN A THOMPSON MD AND PETER J TAYLOR MD
Entity Type:Organization
Organization Name:STEVEN A THOMPSON MD AND PETER J TAYLOR MD
Other - Org Name:TAHOE FOREST WOMENS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-587-1041
Mailing Address - Street 1:10175 LEVONE AVE
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-4821
Mailing Address - Country:US
Mailing Address - Phone:530-587-1041
Mailing Address - Fax:530-587-1444
Practice Address - Street 1:10175 LEVONE AVE
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-4821
Practice Address - Country:US
Practice Address - Phone:530-587-1041
Practice Address - Fax:530-587-1444
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEVEN A THOMPSON MD AND PETER J TAYLOR MD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-16
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207V00000X
CAG54654207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID NUMBER
CAZZZ30893ZMedicare PIN
CAZZZ30893ZMedicare ID - Type Unspecified