| Grover Gene Shipman, MD | |
|
914 Pine Street, Mount Shasta, CA 96067-2143 | |
| (530) 926-6111 | |
| Not Available |
| Full Name | Grover Gene Shipman |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 914 Pine Street, Mount Shasta, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104929017 | NPI | - | NPPES |
| 00A967380 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | MD25595 (Oregon) | Primary |
| Entity Name | Siskiyou Hospital Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1093892275 PECOS PAC ID: 1254223134 Enrollment ID: O20071213000624 |
| Entity Name | Mount Eddy Emergency Physicians Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Other |
| Entity Identifiers | NPI Number: 1316299787 PECOS PAC ID: 7416100714 Enrollment ID: O20130118000029 |
| Mailing Address | Practice Location Address |
|---|---|
| Grover Gene Shipman, MD P.o. Box 12259, Westminster, CA 92685-2259 Ph: (888) 634-8405 | Grover Gene Shipman, MD 914 Pine Street, Mount Shasta, CA 96067-2143 Ph: (530) 926-6111 |
Dr. Gary Allen Herfindahl, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 908 Pine St, Mount Shasta, CA 96067 Phone: 530-926-3161 Fax: 530-926-0406 | |
Nathan Henderson Parker, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 914 Pine St, Mount Shasta, CA 96067 Phone: 530-926-9360 | |
Gabriel Ochoa, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 914 Pine St, Mount Shasta, CA 96067 Phone: 530-926-6111 |