Provider Demographics
NPI:1336446566
Name:CARSON TAHOE CARDIOLOGY
Entity Type:Organization
Organization Name:CARSON TAHOE CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, PHYSICIAN PRACTICE MGT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-445-7290
Mailing Address - Street 1:1470 MEDICAL PKWY
Mailing Address - Street 2:SUITE 160
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-4648
Mailing Address - Country:US
Mailing Address - Phone:775-445-7650
Mailing Address - Fax:775-687-8457
Practice Address - Street 1:1470 MEDICAL PKWY
Practice Address - Street 2:SUITE 160
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4648
Practice Address - Country:US
Practice Address - Phone:775-445-7650
Practice Address - Fax:775-687-8457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-24
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty