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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 (DIRECTOR)
(530) 529-8000
Entity
Organization
Contact information
Practice address
2550 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080-4327
(530) 529-8000
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(818) 340-9988
(818) 587-2493
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CT0220
RAILROAD MEDICARE
CA
05
—
GR0071480
—
CA
01
—
ZZZ52746Z
BLUE SHIELD
CA
Enumeration date
07/17/2006
Last updated
08/22/2020
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