| NPI | 1861626129 |
|---|---|
| Doing Business As | SHASTA COMMUNITY MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | VENKAMMA REDDY President 760-241-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA 26633) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA 26633) |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2009-05-14 |