SHASTA COMMUNITY MEDICAL GROUP – NPI #1861626129
Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

SHASTA COMMUNITY MEDICAL GROUP is a surgeon located in REDDING, CA. NPPES has assigned the NPI number 1861626129 to SHASTA COMMUNITY MEDICAL GROUP on May 14, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SHASTA COMMUNITY MEDICAL GROUP” is a dba name, the actual legal business name for this organization is SHASTA REGIONAL MEDICAL GROUP INC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2086S0129X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Vascular Surgery

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SHASTA COMMUNITY MEDICAL GROUP below.

NPI Profile for
SHASTA REGIONAL MEDICAL GROUP INC

NPI Number
1861626129
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SHASTA REGIONAL MEDICAL GROUP INC
Doing Business As (dba): SHASTA COMMUNITY MEDICAL GROUP
Primary location
1555 EAST ST STE 210
REDDING, CA 96001-1153
Phone: (530) 244-8316 Fax:
Mailing address
16850 BEAR VALLEY RD
VICTORVILLE, CA 92395-5794
Phone: (760) 241-8000 Fax: (760) 962-8021
Organization Subpart
No
Authorized Official
VENKAMMA REDDY
PRESIDENT
Phone: (760) 241-8000
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0129X
- Surgery / Vascular Surgery (Primary)
CA 26633
208G00000X
- Thoracic Surgery (Cardiothoracic Vascular Surgery)
CA 26633

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.