| Shasta Eye Medical Group Inc | |
|
3190 Churn Creek Rd, Redding, CA 96002-2122 | |
| (530) 223-2500 | |
| (530) 226-1375 |
| Full Name | Shasta Eye Medical Group Inc |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 3190 Churn Creek Rd, Redding, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346235603 | NPI | - | NPPES |
| GR0084930 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | Catherine Pham |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1760474159 PECOS PAC ID: 6709783525 Enrollment ID: I20031218000296 |
| Provider Name | Nancy C Ekelund |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1215910641 PECOS PAC ID: 7618958802 Enrollment ID: I20040526000396 |
| Provider Name | Robert Fox |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1508869819 PECOS PAC ID: 8527048511 Enrollment ID: I20040723000510 |
| Provider Name | Bryan G Crum |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1902891385 PECOS PAC ID: 9537124086 Enrollment ID: I20041123000873 |
| Provider Name | Christopher Nmi Lin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1811982291 PECOS PAC ID: 9739180225 Enrollment ID: I20070212000602 |
| Provider Name | Bruce E Silverstein |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1255326476 PECOS PAC ID: 4789628611 Enrollment ID: I20070212000621 |
| Provider Name | Robert G Trent |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1114913761 PECOS PAC ID: 0648271130 Enrollment ID: I20070301000679 |
| Provider Name | Harmohina Bagga |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1306024104 PECOS PAC ID: 2668530692 Enrollment ID: I20081021000221 |
| Provider Name | Tiffany Nichole Pena |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134324163 PECOS PAC ID: 4284726407 Enrollment ID: I20130305000202 |
| Provider Name | Michael Sota Jitosho |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740767201 PECOS PAC ID: 0840538617 Enrollment ID: I20190222000355 |
| Provider Name | Christopher B Myers |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1023088770 PECOS PAC ID: 8224920046 Enrollment ID: I20220705001389 |
| Mailing Address | Practice Location Address |
|---|---|
| Shasta Eye Medical Group Inc Po Box 398986, San Francisco, CA 94139-5898 Ph: (530) 223-2500 | Shasta Eye Medical Group Inc 3190 Churn Creek Rd, Redding, CA 96002-2122 Ph: (530) 223-2500 |