Organization
SHASTA REGIONAL MEDICAL GROUP INC
Active
Other names
SHASTA COMMUNITY MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VENKAMMA REDDY MD (PRESIDENT)
(530) 605-4263
Entity
Organization
Contact information
Practice address
1355 EAST ST STE 200, REDDING, CA 96001-0801
(530) 605-4263
Mailing address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5794
(760) 241-8000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
12/01/2008
Last updated
08/30/2019
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