Most Relevant Information
Provider Data
| NPI Number: | 1003398611 |
| Provider Name: | MICHELLE SORAYA POURTABIB MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207Q00000X |
| Specialty: | Family Medicine |
| License Number: | A177647 |
Most Important Dates
| Enumeration Date: | 08/30/2018 |
| Last Updated: | 09/23/2024 |
Provider Practice Location
12030 DONNER PASS RD STE 1-720
TRUCKEE
CA
961610449
Practice Location Phone/Fax
| Phone: | 9162585827 |
| Fax: |
Provider Mailing Location
12030 DONNER PASS RD STE 1-720
TRUCKEE
CA
961610449
Provider Mailing Phone/Fax
| Phone: | 9162585827 |
| Fax: |
Suggested EMR
Family Practice EMR