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1345 A Paul Bunyan Rd Susanville CA 96130-3159 | |
| (530) 252-2235 | |
| (530) 252-2241 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1345 A Paul Bunyan Rd, Susanville, California |
| Authorized Official Name and Position | Dennis Laraway (CFO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | 1345 A Paul Bunyan Rd Susanville CA 96130-3159 Ph: (530) 252-2235 |
| NPI Number | 1205267549 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 01/31/2022 |
| Medicare PECOS PAC ID | 9537078365 |
|---|---|
| Medicare Enrollment ID | O20140604002057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205267549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Thomas L Bosshardt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104958156 PECOS PAC ID: 2163497413 Enrollment ID: I20040830000909 |
| Provider Name | Jeffry Gill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477654747 PECOS PAC ID: 0941278279 Enrollment ID: I20040924000195 |
| Provider Name | Robert G Leckie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861490559 PECOS PAC ID: 6103719042 Enrollment ID: I20050214000322 |
| Provider Name | Randall Allan Pierce |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174511067 PECOS PAC ID: 3971576182 Enrollment ID: I20050214000414 |
| Provider Name | Mercedeh Baghai |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528014644 PECOS PAC ID: 3274507082 Enrollment ID: I20061221000393 |
| Provider Name | Cecilia Bacerdo Geralde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699979062 PECOS PAC ID: 7113088956 Enrollment ID: I20081211000417 |
| Provider Name | George H Barakat |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437131067 PECOS PAC ID: 3173717535 Enrollment ID: I20101029000229 |
| Provider Name | Mark T Reis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982709432 PECOS PAC ID: 3375448269 Enrollment ID: I20120222000577 |
| Provider Name | Jeffrey S Fountain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245420447 PECOS PAC ID: 7517141377 Enrollment ID: I20120530000222 |
| Provider Name | Kristian L Brown |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023272051 PECOS PAC ID: 7416193735 Enrollment ID: I20130411000211 |
| Provider Name | Bess E Brackett |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043269491 PECOS PAC ID: 9931137783 Enrollment ID: I20141223001295 |
| Provider Name | Timothy Chinnock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356505218 PECOS PAC ID: 3274843750 Enrollment ID: I20151112002772 |
| Provider Name | Steven J Lalliss |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437130655 PECOS PAC ID: 9335329184 Enrollment ID: I20160705001403 |
| Provider Name | John C Kurylo |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467611988 PECOS PAC ID: 0547400921 Enrollment ID: I20160725002848 |
| Provider Name | Sara Forouhar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871937946 PECOS PAC ID: 6305125477 Enrollment ID: I20170315000632 |
| Provider Name | Michael Raymond Warmoth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215932207 PECOS PAC ID: 4587852454 Enrollment ID: I20170418001874 |
| Provider Name | Laura Ellen Sullivan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386805794 PECOS PAC ID: 6901091016 Enrollment ID: I20180124001100 |
| Provider Name | Matthew J Kolosky |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023459211 PECOS PAC ID: 8921368226 Enrollment ID: I20180206001394 |
| Provider Name | Juan N Walterspiel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730458787 PECOS PAC ID: 9739440470 Enrollment ID: I20180221000797 |
| Provider Name | Brett J Schulte |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285637579 PECOS PAC ID: 1052507720 Enrollment ID: I20180820003298 |
| Provider Name | Damian M Ray |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477993533 PECOS PAC ID: 7012207335 Enrollment ID: I20191231001441 |
| Provider Name | Kellie L Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043844947 PECOS PAC ID: 8022449081 Enrollment ID: I20200507003012 |
| Provider Name | Sanjay Shah |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285694778 PECOS PAC ID: 8628161882 Enrollment ID: I20210105001848 |
| Provider Name | Eric J Kraemer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881621621 PECOS PAC ID: 1153429469 Enrollment ID: I20210607000679 |
| Provider Name | Geoffrey Rohlfing |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811382963 PECOS PAC ID: 1759783046 Enrollment ID: I20210708003054 |
| Provider Name | Tobias Alexander Handschin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598184343 PECOS PAC ID: 9032454178 Enrollment ID: I20230822000993 |
| Provider Name | William D Murrell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134109572 PECOS PAC ID: 9638164353 Enrollment ID: I20231027003315 |
| Provider Name | Marie Gessel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710151196 PECOS PAC ID: 4587989181 Enrollment ID: I20241001002901 |
| Provider Name | Joseph Loring |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538622154 PECOS PAC ID: 9335476449 Enrollment ID: I20241030001512 |
Marshall Healthcare Systems Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 170 Russell Ave, Suite L, Susanville, CA 96130 Phone: 530-313-5529 Fax: 530-387-3581 | |
Jay M Beams Md,inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Nevada St, Susanville, CA 96130 Phone: 530-257-4137 | |
F Kuliyev Pllc Ltd Fuad Kuliyev Sole Mbr Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1800 Spring Ridge Dr, Susanville, CA 96130 Phone: 530-252-2000 | |
S Pannu Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1800 Spring Ridge Dr, Susanville, CA 96130 Phone: 530-252-2000 | |
Jay M Beams Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 Nevada St, Susanville, CA 96130 Phone: 530-257-4137 Fax: 530-257-4005 |