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Organization
MT SHASTA HOSPITALIST SERVICES INC
Active
Organization
MT SHASTA HOSPITALIST SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN MALEE MD (PRESIDENT)
(530) 926-6111
Entity
Organization
Contact information
Practice address
914 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-6111
Mailing address
PO BOX 496084, REDDING, CA 96049-6084
(530) 926-6111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FNP39583
FICTITIOUS NAME PERMIT
CA
Enumeration date
05/27/2010
Last updated
03/30/2012
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