| Organization Name: | SIERRA NEVADA MEDICAL GROUP |
| NPI Number: | 1730153826 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID HOWARD JOHNSON (PRESIDENT) |
| Mailing Address: | 1624 Library Lane Suite B Minden |
| State: | NV US |
| Postal Code: | 89423 |
| Phone Number: | 7757828186 |
| Fax Number: | 7757824683 |
| NPI Enumeration Date: | 02/15/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |