| Banner Health Physicians West Llc | |
|
1800 Spring Ridge Dr Susanville CA 96130-6100 | |
| (530) 252-2225 | |
| Not Available |
| Full Name | Banner Health Physicians West Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1800 Spring Ridge Dr, Susanville, California |
| Authorized Official Name and Position | Dennis Laraway (CFO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Health Physicians West Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner Health Physicians West Llc 1800 Spring Ridge Dr Susanville CA 96130-6100 Ph: (530) 252-2225 |
| NPI Number | 1881950541 |
|---|---|
| Provider Enumeration Date | 04/06/2012 |
| Last Update Date | 02/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881950541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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