Organization
CANCER CARE CONSULTANTS OF NORTHERN CALIFORNIA A MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER STAHL (OFFICE MANGER)
(530) 244-2223
Entity
Organization
Contact information
Practice address
902 PINE ST, MOUNT SHASTA, CA 96067-2143
(530) 926-7234
(530) 926-7231
Mailing address
PO BOX 993100, REDDING, CA 96099-3100
(530) 244-2223
(530) 244-4799
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0054240
—
CA
Enumeration date
08/10/2006
Last updated
11/08/2007
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