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Organization
MT SHASTA MEDI-CAL CLINIC, INC
Active
Organization
MT SHASTA MEDI-CAL CLINIC, INC
Active
Other names
Alpine Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS BAYLESS CMPE (EXECUTIVE DIRECTOR)
(530) 926-5105
Entity
Organization
Contact information
Practice address
912 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-5105
(530) 926-1359
Mailing address
912 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-5105
(530) 926-1359
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
230000075
CA
Other
Enumeration date
06/10/2006
Last updated
08/04/2009
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