| Peak Medical Tahoe | |
|
2229 Barton Ave South Lake Tahoe CA 96150-3411 | |
| (530) 539-4781 | |
| (530) 238-6403 |
| Full Name | Peak Medical Tahoe |
|---|---|
| Speciality | Family Medicine |
| Location | 2229 Barton Ave, South Lake Tahoe, California |
| Authorized Official Name and Position | Tyler Peterson (MD/OWNER) |
| Authorized Official Contact | 2816025959 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peak Medical Tahoe 2229 Barton Ave South Lake Tahoe CA 96150-3411 Ph: () - | Peak Medical Tahoe 2229 Barton Ave South Lake Tahoe CA 96150-3411 Ph: (530) 539-4781 |
| NPI Number | 1437938297 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 03/20/2024 |
| Medicare PECOS PAC ID | 4284081530 |
|---|---|
| Medicare Enrollment ID | O20231108003443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437938297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Tyler Alan Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467800243 PECOS PAC ID: 9638464597 Enrollment ID: I20201104000184 |
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