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Organization
SHASTA REGIONAL MEDICAL GROUP INC
Active
Organization
SHASTA REGIONAL MEDICAL GROUP INC
Active
Other names
SHASTA COMMUNITY MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VENKAMMA REDDY MD (PRESIDENT)
(530) 605-4263
Entity
Organization
Contact information
Practice address
1355 EAST ST STE 200, REDDING, CA 96001-0801
(530) 605-4263
Mailing address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5794
(760) 241-8000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
12/01/2008
Last updated
08/30/2019
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