CLEAR CREEK MEDICAL CORP


Address: 1100 Butte St, Redding, CA 96001-0852
Phone: 5302445400

CLEAR CREEK MEDICAL CORP (NPI# 1629583018) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629583018
Entity Type Organization
Organization Name CLEAR CREEK MEDICAL CORP
Practice Address 1100 Butte St
Redding
CA 96001-0852
Mailing Address 738 Sunriver Ln
Redding
CA 96001-0166
Practice Telephone 5302445400
Mailing Telephone 5303552670
Enumeration Date 2017-12-06
Last Update Date 2018-03-17
Authorized Official Name DR. GREG GREENBERG (CEO)
Authorized Official Telephone 5303552670
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QA0401X Family Medicine
Specialization: Addiction Medicine
A86727 CA Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
2801 Eureka Way, Redding, CA 960010222 5302469000

Office Location

Street Address 1100 BUTTE ST
City REDDING
State CA
Zip Code 96001-0852

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073580577 Pavan K Davuluri Anesthesiology 1100 Butte St, Redding, CA 96001 2006-03-02
1487255816 Jessica Ann Kandybe Registered Nurse 1100 Butte St, Redding, CA 96001-0852 2020-11-03
1306474135 Tai Chinnock Moses Physician Assistant 1100 Butte St, Redding, CA 96001-0852 2020-03-28
1073150025 Carl Evan Bennett Nurse Practitioner 1100 Butte St, Redding, CA 96001-0852 2019-12-09
1427604636 Maria C Morales Nurse Practitioner 1100 Butte St, Redding, CA 96001-0852 2019-08-13
1962982165 Eric Lee Svendsen Physician Assistant 1100 Butte St, Redding, CA 96001 2018-08-16
1174017214 Far Northern Anesthesia Consultants Anesthesiology 1100 Butte St, Redding, CA 96001 2018-06-21
1457879009 Noah Chutz Physician Assistant 1100 Butte St, Redding, CA 96001 2017-09-05
1679007140 Shasta Regional Emergency Medical Associates, Inc Emergency Medicine 1100 Butte St, Redding, CA 96001-0852 2017-04-12
1285185397 Zachary Periharos Physician Assistant 1100 Butte St, Redding, CA 96001-0852 2016-10-24
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1730651266 Vanessa Louise Banda Social Worker 1544 Magnolia Avenue, Redding, CA 96001 2018-12-21
1184194672 Marie Sherrick Licensed Vocational Nurse 2030 Elreno Lane, Redding, CA 96001 2018-11-28
1699257857 Prorehab Physical Therapy and Sports Performance, Inc Physical Therapist 3673 Eureka Way, Redding, CA 96001 2018-09-05
1316456833 Jennifer Rose Goehring Counselor 1310 Continental Street, Redding, CA 96001 2017-09-27
1891224440 Audrey Cutler Social Worker 1313 Yuba St., Redding, CA 96001 2017-06-07
1184167991 Calafia Holdings LLC Skilled Nursing Facility 1836 Gold Street, Redding, CA 96001 2016-11-28
1194272369 Shasta County Clinic/Center 2950 Polk Street, Rooms 2, 3, 4, Redding, CA 96001 2016-09-06
1417329236 Shari Hayden Specialist/Technologist, Other 2111 Air Park Dr, Redding, CA 96001 2015-10-21
1679951982 Shasta Hearing Aids Health Maintenance Organization 900 Butte St, Redding, CA 96001 2015-05-07
1073919171 Native American Mental Health Services Corporation Psychiatry & Neurology 1742 Oregon Street, Redding, CA 96001 2014-11-17
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Taxonomy Information

Taxonomy Code 207QA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Addiction Medicine

Taxonomy Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710073887 North Valley Medical Corporation Family Medicine 473 South St, Redding, CA 96001-2105 2006-10-05

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1194332726 True North Detox LLC Family Medicine 2413 Whitmore Ave, Clovis, CA 93619-9252 2020-09-28
1639717473 Michael Stone Md Inc Family Medicine 1950 E 17th St Ste 101, Santa Ana, CA 92705-6852 2019-12-11
1720624497 Marina Harbor Detox Family Medicine 289 Marina Blvd, San Francisco, CA 94123-1212 2019-11-18
1093363848 Anthony Martin Ocana Family Medicine 13924 Marquesas Way Apt 1520, Marina Del Rey, CA 90292-6018 2019-08-26
1821640137 L Snyder Incorporated Family Medicine 34052 La Plaza #101, Dana Point, CA 92629 2019-07-16
1720645328 Creative Child and Family Services, Inc. Family Medicine 7049 Ohio River Dr, Eastvale, CA 91752 2019-05-20
1932666575 Gold Country Health Initiative, LLC Family Medicine 820/830 State Highway 88, Jackson, CA 95642 2019-03-01
1629550660 University of California Sfgh Medical Group Family Medicine 1001 Potrero Ave Rm 5h22, San Francisco, CA 94110-3518 2018-09-06
1952809592 Sunrise Health & Wellness Center, LLC Family Medicine 10089 Folsom Blvd. Suites A & C, Rancho Cordova, CA 95670-1935 2018-01-29
1487166120 Good Samaritan Shelter Family Medicine 412 East Tunnell Street, Santa Maria, CA 93454 2017-11-03
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Competitor

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City REDDING
Zip Code 96001

Improve Information

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Dataset Information

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.

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