| Lake Shastina Medical Clinic Inc | |
|
16337 Everhart Dr Weed CA 96094-9400 | |
| (530) 938-2297 | |
| (530) 938-0494 |
| Full Name | Lake Shastina Medical Clinic Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 16337 Everhart Dr, Weed, California |
| Authorized Official Name and Position | Phillip M Miller (CEO) |
| Authorized Official Contact | 5309382297 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Shastina Medical Clinic Inc 16337 Everhart Dr Weed CA 96094-9400 Ph: (530) 938-2297 | Lake Shastina Medical Clinic Inc 16337 Everhart Dr Weed CA 96094-9400 Ph: (530) 938-2297 |
| NPI Number | 1356331615 |
|---|---|
| Provider Enumeration Date | 10/26/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356331615 | NPI | - | NPPES |
| GR0098510 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Weed Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 50 Alamo Ave, Weed, CA 96094 Phone: 530-999-9050 Fax: 530-938-2662 | |
Mercy Lake Shastina Community Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16337 Everhart Dr, Weed, CA 96094 Phone: 530-938-2297 Fax: 530-938-0494 | |
Shasta Regional Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Alamo Ave, Weed, CA 96094 Phone: 530-605-4263 |