| Miriam Locke, MD | |
|
2169 South Ave, South Lake Tahoe, CA 96150-7059 | |
| (530) 543-5400 | |
| Not Available |
| Full Name | Miriam Locke |
|---|---|
| Gender | Female |
| Speciality | Urology |
| Location | 2169 South Ave, South Lake Tahoe, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225455157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | A162641 (California) | Primary |
| Entity Name | Northbay Healthcare Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821147786 PECOS PAC ID: 0042122244 Enrollment ID: O20031105000409 |
| Entity Name | Barton Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750950499 PECOS PAC ID: 5395127682 Enrollment ID: O20220803001208 |
| Mailing Address | Practice Location Address |
|---|---|
| Miriam Locke, MD 2169 South Ave, South Lake Tahoe, CA 96150-7059 Ph: (530) 543-5400 | Miriam Locke, MD 2169 South Ave, South Lake Tahoe, CA 96150-7059 Ph: (530) 543-5400 |
Dr. Bradley W Anderson, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2169 South Ave, South Lake Tahoe, CA 96150 Phone: 530-543-5400 Fax: 530-544-1959 | |
Brian L Steixner, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2169 South Ave, South Lake Tahoe, CA 96150 Phone: 530-543-5400 |