Healthcare Provider Details

I. General information

NPI: 1649603713
Provider Name (Legal Business Name): REDDING SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 WEST ST
REDDING CA
96001-0415
US

IV. Provider business mailing address

1238 WEST ST
REDDING CA
96001-0415
US

V. Phone/Fax

Practice location:
  • Phone: 530-241-5499
  • Fax: 530-242-9471
Mailing address:
  • Phone: 530-241-5499
  • Fax: 530-242-9471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: TRACI KINGSBURY
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 530-241-5499