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 M.D. (PRESIDENT)
(760) 241-8000
Entity
Organization
Contact information
Practice address
1555 EAST ST STE 210, REDDING, CA 96001-1153
(530) 244-8316
Mailing address
16850 BEAR VALLEY RD, VICTORVILLE, CA 92395-5794
(760) 241-8000
(760) 962-8021
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
26633
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
26633
CA
Other
Enumeration date
05/14/2009
Last updated
05/14/2009
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