# MT SHASTA MEDI-CAL CLINIC, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Alpine Healthcare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679514483
- **Authorized official:** CHRIS BAYLESS CMPE (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (530) 926-5105

## Contact information

- **Practice address:** 912 PINE ST, MOUNT SHASTA, CA 96067-2143
- **Practice address phone:** (530) 926-5105
- **Practice address fax:** (530) 926-1359
- **Mailing address:** 912 PINE ST, MOUNT SHASTA, CA 96067-2143
- **Mailing address phone:** (530) 926-5105
- **Mailing address fax:** (530) 926-1359

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 230000075 | CA | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 08/04/2009