MOUNT SHASTA PHYSICIANS INC (NPI# 1265889562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265889562 |
| Entity Type | Organization |
| Organization Name | MOUNT SHASTA PHYSICIANS INC |
| Practice Address |
444 Bruce St Yreka CA 96097-3450 |
| Practice Telephone | 5309494862 |
| Practice Fax Number | 5302425039 |
| Mailing Telephone | 5309494862 |
| Mailing Fax Number | 5302425039 |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2016-05-17 |
| Authorized Official Name | DR. DAN C PURTZER (PRESIDENT) |
| Authorized Official Telephone | 5309494862 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 56103 | CA | Other Service Providers |
| Street Address |
444 BRUCE ST |
| City | YREKA |
| State | CA |
| Zip Code | 96097-3450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043213549 | Dan C Purtzer | Pathology | 444 Bruce St, Yreka, CA 96097-3450 | 2005-05-27 |
| 1710530696 | Nina Yaftali | Internal Medicine | 444 Bruce St, Yreka, CA 96097-3450 | 2019-07-19 |
| 1467011627 | Saiba Hospitalist Associates | Internal Medicine | 444 Bruce St, Yreka, CA 96097-3450 | 2019-06-11 |
| 1922577535 | Marble Mountain Anesthesia, Inc., A Professional Nursing Corporation | Nurse Anesthetist, Certified Registered | 444 Bruce St, Yreka, CA 96097-3450 | 2018-11-14 |
| 1205335072 | Kim Marie Keller | Registered Nurse | 444 Bruce St, Yreka, CA 96097-3450 | 2018-02-07 |
| 1558873786 | Samuel C Birkholz | Nurse Anesthetist, Certified Registered | 444 Bruce St, Yreka, CA 96097-3450 | 2017-10-27 |
| 1710334677 | Nepomuceno Hospital Group Inc | Family Medicine | 444 Bruce St, Yreka, CA 96097-3450 | 2016-05-20 |
| 1093198764 | Premier Health Services Inc | Internal Medicine | 444 Bruce St, Yreka, CA 96097-3450 | 2015-06-30 |
| 1336537174 | Cameron Thomas Lovinger | Nurse Anesthetist, Certified Registered | 444 Bruce St, Yreka, CA 96097-3450 | 2015-01-01 |
| 1952701369 | Siskiyou Hospital, Inc. | General Acute Care Hospital | 444 Bruce St, Yreka, CA 96097-3450 | 2014-09-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376830653 | Paul William Willis | Pharmacist | 807 S. Main St., Yreka, CA 96097 | 2011-07-07 |
| 1578883864 | Ginger A Bert | Chiropractor | 106 Ranch Ln Ste A, Yreka, CA 96097 | 2010-06-09 |
| 1669796611 | Rebekah Joyce Retterath | Dietitian, Registered | 444 Bruce Street, Yreka, CA 96097 | 2010-03-19 |
| 1780849679 | Donna Jean May | Marriage & Family Therapist | 625 Butte Street, Yreka, CA 96097 | 2008-07-21 |
| 1114121589 | Loren Cronk | Marriage & Family Therapist | 208 4th Street, Yreka, CA 96097 | 2007-06-12 |
| 1093928863 | Kristin Rene Kopplin | Psychologist | 1515 South Oregon Street, Suite A, Yreka, CA 96097 | 2007-05-08 |
| 1073735379 | Rivkah Lynn Barmore | Social Worker | 1515 S Oregon, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1649492091 | Randy Terry Murieen | Social Worker | 1515 S Oregon Street, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1265654537 | Roy Victor Hall Jr. | Social Worker | 1515 South Oregon St, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1578785614 | Meadowlark | Assisted Living Facility | 351 Bruce St, Yreka, CA 96097 | 2007-05-02 |
| Find all providers in zip 96097 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1073111936 | Griffin Nutrition Xterem | Specialist | 21575 Dome Trl, Topanga, CA 90290-3645 | 2020-10-13 |
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| 1417572462 | Sarah Velez | Specialist | 1001 Potrero Ave Rm 7g19, San Francisco, CA 94110-3518 | 2020-06-15 |
| 1295350668 | Bette Graff | Specialist | 4148 10th St, Riverside, CA 92501-3110 | 2020-06-11 |
| 1114541463 | Serena Mink | Specialist | 100 Park Plz Apt 407, San Diego, CA 92101-6710 | 2020-06-02 |
| 1811510043 | Michael J Kodrich | Specialist | 40555 California Oaks Rd, Murrieta, CA 92562-5723 | 2020-05-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.