| Mt Shasta Hospitalist Services Inc | |
|
914 Pine St Mount Shasta CA 96067-2143 | |
| (530) 926-6111 | |
| Not Available |
| Full Name | Mt Shasta Hospitalist Services Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 914 Pine St, Mount Shasta, California |
| Authorized Official Name and Position | Sean Malee (PRESIDENT) |
| Authorized Official Contact | 5309266111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mt Shasta Hospitalist Services Inc Po Box 496084 Redding CA 96049-6084 Ph: (530) 926-6111 | Mt Shasta Hospitalist Services Inc 914 Pine St Mount Shasta CA 96067-2143 Ph: (530) 926-6111 |
| NPI Number | 1356660559 |
|---|---|
| Provider Enumeration Date | 05/27/2010 |
| Last Update Date | 03/30/2012 |
| Medicare PECOS PAC ID | 4486786209 |
|---|---|
| Medicare Enrollment ID | O20100714000634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356660559 | NPI | - | NPPES |
| FNP39583 | Other | CA | FICTITIOUS NAME PERMIT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sean Derek Malee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447343447 PECOS PAC ID: 4789576091 Enrollment ID: I20040329001716 |
| Provider Name | Ellen K Schoenfelder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306912035 PECOS PAC ID: 2769670231 Enrollment ID: I20151007001154 |
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