Organization
SHASTA EYE SURGEONS INC
Active
Other names
Surgery Center of Northern California
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE L NEAL (ASSISTANT SECRETARY)
(844) 377-6468
Entity
Organization
Contact information
Practice address
950 BUTTE ST, REDDING, CA 96001-0827
(530) 223-2500
(530) 241-1408
Mailing address
950 BUTTE ST, REDDING, CA 96001-0827
(530) 223-2500
(530) 241-1408
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
051087
CA
261QS0132X
Ophthalmologic Surgery Clinic/Center
051087
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490004349
RR MEDICARE
—
05
—
SUR01087H
—
CA
Enumeration date
09/13/2005
Last updated
02/05/2020
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