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NPI Code Detail

MEDICARE: YVONNE SCOTT CALLISON PA

MEDICARE: YVONNE SCOTT CALLISON PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant62178CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396837332
Entity Type Code : Individual
Provider Name (Legal Business Name) : YVONNE SCOTT CALLISON PA
Provider Business Mailing Address
First Line : PO BOX 1196
Second Line :
City : SUSANVILLE
State : CA
Zip : 96130-1196
Country : US
Telephone Number : 775-379-0785
Fax Number :
Provider Business Practice Location Address
First Line : 1742 OREGON ST
Second Line :
City : REDDING
State : CA
Zip : 96001-1717
Country : US
Telephone Number : 530-251-6523
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2006
Last Update Date : 10/03/2024

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Directions to “ YVONNE SCOTT CALLISON PA” Practice Location

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