Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Cory T Hall, PAC

Individual provider Physician Assistant · NPI 1093706558

Cory T Hall, PAC is a Physician Assistant in South Lake Tahoe, California. Licensed in California and Nevada. Registered with an NPI since 2005.

Licensed in
CA, NV
In the registry since
2005
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

1139 3rd St
South Lake Tahoe, CA 96150-3465
Phone: (530) 541-3100
Fax: (530) 541-3016
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA15806 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA678 (NV)

Record details

NPI number1093706558
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedNovember 3, 2005
Last updated in NPPESNovember 16, 2007

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