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Organization
GOOD MEDICINE A MEDICAL CORPORATION
Active
Organization
GOOD MEDICINE A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA KOEHLER (BUSINESS MANAGER)
(530) 926-5100
Entity
Organization
Contact information
Practice address
101 OLD MCCLOUD RD, MOUNT SHASTA, CA 96067-2796
(530) 926-5100
(530) 926-1859
Mailing address
101 OLD MCCLOUD RD, MOUNT SHASTA, CA 96067-2796
(530) 926-5100
(530) 926-1859
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF3805
RAILROAD MEDICARE
CA
Enumeration date
03/05/2007
Last updated
03/13/2008
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