Healthcare Provider Details

I. General information

NPI: 1811256423
Provider Name (Legal Business Name): MED-LEGAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 10/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 SUTTER HILL RD STE B
SUTTER CREEK CA
95685-4254
US

IV. Provider business mailing address

460 SUTTER HILL RD STE B
SUTTER CREEK CA
95685-4254
US

V. Phone/Fax

Practice location:
  • Phone: 209-267-8197
  • Fax: 877-295-5935
Mailing address:
  • Phone: 209-267-8197
  • Fax: 877-295-5935

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1744R1103X
TaxonomyResearch Study Abstracter/Coder
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code209800000X
TaxonomyLegal Medicine (M.D./D.O.) Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. CYNTHIA M MASTERS
Title or Position: CEO/CFO
Credential:
Phone: 606-262-7589