Healthcare Provider Details
I. General information
NPI: 1427349976
Provider Name (Legal Business Name): REDDING OCCUPATIONAL MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2011
Last Update Date: 05/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1710 CHURN CREEK RD
REDDING CA
96002-0236
US
IV. Provider business mailing address
PO BOX 99740
EMERYVILLE CA
94662-9740
US
V. Phone/Fax
- Phone: 530-646-4242
- Fax: 530-646-4243
- Phone: 530-646-4242
- Fax: 530-646-4243
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | G58556 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | G58556 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
STEVEN
A
GEST
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 530-646-4242