Organization
SISKIYOU EYE CENTER, MEDICAL GROUP, INC
Active
Other names
Siskiyou Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BELMIRA PARDAL BORG (ADMINISTRATOR)
(530) 842-2760
Entity
Organization
Contact information
Practice address
2524 WESTSIDE RD, YREKA, CA 96097-9129
(530) 842-2760
(530) 842-5839
Mailing address
2524 WESTSIDE RD, YREKA, CA 96097-9129
(530) 842-2760
(530) 842-5839
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
FNP26049
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ550452
BXBS OF CA
CA
Enumeration date
06/13/2005
Last updated
03/11/2010
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