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Organization
SHASTA EMERGENCY MEDICAL GROUP
Active
Organization
SHASTA EMERGENCY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT S HAMILTON MD (MEDICAL DIRECTOR)
(530) 225-7241
Entity
Organization
Contact information
Practice address
2175 ROSALINE AVE, REDDING, CA 96001-2509
(530) 225-6000
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(866) 237-6336
(818) 587-2493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI2804
RAILROAD MEDICARE
CA
01
—
CT0220
RAILROAD MEDICARE
CA
05
—
GR0054400
—
CA
05
—
GR0071480
—
CA
01
—
ZZZ35444Z
BLUE SHIELD
CA
01
—
ZZZ52746Z
BLUE SHIELD
CA
Enumeration date
05/20/2006
Last updated
08/22/2020
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