Organization
REDDING PRIMARY CARE MEDICAL GROUP, INC
Active
Parent organization
REDDING PRIMARY CARE MEDICAL GROUP, INC.
Other names
HILLTOP MEDICAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
REDDING PRIMARY CARE MEDICAL GROUP, INC.
Authorized official
LINDA YVONNE FULLERTON (CO-ADMINISTRATOR)
(530) 221-1565
Entity
Organization
Contact information
Practice address
1093 HILLTOP DRIVE, REDDING, CA 96003-3811
(530) 221-1565
(530) 221-3912
Mailing address
1093 HILLTOP DRIVE, REDDING, CA 96003-3811
(530) 221-1565
(530) 221-3912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A86612
CA
207Q00000X
Family Medicine Physician
G63898
CA
207Q00000X
Family Medicine Physician
G70179
CA
207R00000X
Internal Medicine Physician
G42236
CA
261QU0200X
Urgent Care Clinic/Center
BUSS LIC #9113
CA
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0618250
CLIA #
CA
Enumeration date
07/19/2006
Last updated
09/05/2012
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