Organization
PLASTIC SURGERY ASSOCIATES OF REDDING A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK D BALL MD (PRESIDENT)
(530) 241-1300
Entity
Organization
Contact information
Practice address
2439 SONOMA ST, SUITE 101, REDDING, CA 96001-3026
(530) 241-1300
(530) 241-0200
Mailing address
2439 SONOMA ST, SUITE 101, REDDING, CA 96001-3026
(530) 241-1300
(530) 241-0200
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0057070
—
CA
01
—
ZZZ37414Z
MEDICARE GROUP ID
CA
Enumeration date
01/05/2007
Last updated
02/22/2012
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