Hall, Cory T

Hall, Cory T is an individual health care provider with primary practice located at 1139 3Rd St , South Lake Tahoe CA 96150-3465. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Hall, Cory T can be contacted via phone (530) 541-3100.

Contact Information

Primary practice address
1139 3Rd St South Lake Tahoe CA 96150-3465
Phone: (530) 541-3100
Fax: (530) 541-3016
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA15806 California
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA678 Nevada

Profile Details

NPI number 1093706558
LBN Legal business name Hall, Cory T
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated Nov 16th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093706558 NPPES
Nevada Other CC1490 BCBS

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