Organization
REDDING PRIMARY CARE MEDICAL GROUP, INC
Active
Other names
Hilltop Medical Clinic West
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA YVONNE FULLERTON (ADMINISTRATOR)
(530) 221-1565
Entity
Organization
Contact information
Practice address
1093 HILLTOP DR, REDDING, CA 96003-3811
(530) 221-1565
(530) 221-3912
Mailing address
1093 HILLTOP DR, REDDING, CA 96003-3811
(530) 221-1565
(530) 221-3912
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
BUSS LIC# 23151
CA
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1064577
MEDICARE CLIA NUMBER
CA
01
—
ZZZ11432Z
MEDICARE PTAN
CA
Enumeration date
03/21/2007
Last updated
06/16/2021
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