Healthcare Provider Details

I. General information

NPI: 1376631606
Provider Name (Legal Business Name): NORTHERN CALIFORNIA SURGICAL GROUP A MED CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2656 EDITH AVE SUITE B
REDDING CA
96001-3030
US

IV. Provider business mailing address

2656 EDITH AVE SUITE B
REDDING CA
96001-3030
US

V. Phone/Fax

Practice location:
  • Phone: 530-244-2882
  • Fax: 530-244-3703
Mailing address:
  • Phone: 530-244-2882
  • Fax: 530-244-3703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD E SCHEPPS
Title or Position: CEO/PRESIDENT
Credential: M.D.
Phone: 530-244-2882