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General NPI Number Information
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NPI Number | 1598305682
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Entity Type | Organization
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Legal Business Name | NORTH STATE HOSPITALIST MEDICAL GROUP, INC
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 914 PINE ST
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City | MOUNT SHASTA
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State | CA
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Zip | 96067-2143
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Country | US
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Telephone | 530-926-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 4535 DRESSLER RD NW
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City | CANTON
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State | OH
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Zip | 44718-2545
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Country | US
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Telephone | 844-474-4019
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Fax | 330-493-8677
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Authorized Official
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Title or Position | MD
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Name | STEVEN MARON
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Credential | MD
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Telephone | 925-225-5837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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