Individual
DR. GARY ALLEN HERFINDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
908 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-3161
(530) 926-0406
Mailing address
908 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-3161
(530) 926-0406
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
G51667
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
G51667
CA
208600000X
Surgery Physician
G51667
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G516670
BLUE SHIELD OF CALIFORNIA
CA
05
—
00G516670
—
CA
01
—
0662956
CHAMPUS
SC
05
—
172614
—
OR
01
—
G51667
BLUE CROSS OF CALIFORNIA
CA
Enumeration date
07/13/2006
Last updated
09/11/2025
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