# NORTH VALLEY BREAST CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841494366
- **Authorized official:** DR. IAN P GRADY MD (OWNER)
- **Authorized official phone:** (530) 243-5551

## Contact information

- **Practice address:** 1335 BUENAVENTURA BLVD, SUITE \# 204, REDDING, CA 96001-0160
- **Practice address phone:** (530) 243-5551
- **Practice address fax:** (530) 245-0572
- **Mailing address:** 1335 BUENAVENTURA BLVD, SUITE \# 204, REDDING, CA 96001-0160
- **Mailing address phone:** (530) 243-5551
- **Mailing address fax:** (530) 245-0572

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 06/11/2007
- **Last updated:** 07/16/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | ZZZ53955Y | BLUE SHIELD | CA |