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Organization
LASSEN MEDICAL GROUP INC
Active
Organization
LASSEN MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGNES FISCHER (CONTROLLER)
(530) 528-4477
Entity
Organization
Contact information
Practice address
2450 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080-4356
(530) 527-0141
(530) 527-3720
Mailing address
2450 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080-4356
(530) 527-0141
(530) 527-3720
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0089250
—
CA
05
—
LAB18474F
—
CA
05
—
LAB18474G
—
CA
05
—
RHM53955F
—
CA
Enumeration date
02/06/2007
Last updated
06/28/2013
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