Lake Shastina Medical Clinic Inc in Weed - Family Medicine
Lake Shastina Medical Clinic Inc - NPI 1356331615
Lake Shastina Medical Clinic Inc is a Family Medicine in Weed, California. Lake Shastina Medical Clinic Inc practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Lake Shastina Medical Clinic Inc is 1356331615. The last update date is 2020-08-22.
Lake Shastina Medical Clinic Inc's current location address is 16337 Everhart Dr, Weed, California. You can contact this provider via phone number 5309382297 and fax number 5309380494. The mailing address for Lake Shastina Medical Clinic Inc is 16337 Everhart Dr, Weed, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Shastina Medical Clinic Inc |
|---|---|
| Address | 16337 Everhart Dr, Weed, California |
| Phone Number | 5309382297 |
| Fax Number | 5309380494 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Miller M Phillip |
| Credentials | M.D. |
| Telephone Number | 5309382297 |
NPI Number Detail
| NPI Number | 1356331615 |
|---|---|
| Provider Enumeration Date | 2005-10-26 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 16337 Everhart Dr |
|---|---|
| City | Weed |
| State | California (CA) |
| Post Code | 960949400 |
| Phone Number | 5309382297 |
| Fax Number | 5309380494 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| GR0098510 | CA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Lake Shastina Medical Clinic Inc by the Centers for Medicare & Medicaid Services (CMS)?
The Lake Shastina Medical Clinic Inc has been assigned the NPI (National Provider Identifier) 1356331615. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you kindly provide the complete physical address where Lake Shastina Medical Clinic Inc's facilities are geographically located?
The facilities of Lake Shastina Medical Clinic Inc are physically situated at the following location: 16337 Everhart Dr, Weed, CA, 960949400.
What is Lake Shastina Medical Clinic Inc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Lake Shastina Medical Clinic Inc's area of specialization is Family Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Q00000X.
On what date did the Lake Shastina Medical Clinic Inc receive its 1356331615 assignment from the Centers for Medicare & Medicaid Services?
The Lake Shastina Medical Clinic Inc was assigned its 1356331615 by the Centers for Medicare & Medicaid Services on 2005-10-26.
As of what date was the information pertaining to Lake Shastina Medical Clinic Inc, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Lake Shastina Medical Clinic Inc, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-08-22.
NPI Number: 1982607784
Address: 54045 Ridge Rd, Yucca Valley, CA