| Shasta Internal Medicine A Medical Corporation | |
|
3760 Sunlight Ct Redding CA 96001-0173 | |
| (530) 768-4052 | |
| (844) 424-9064 |
| Full Name | Shasta Internal Medicine A Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 3760 Sunlight Ct, Redding, California |
| Authorized Official Name and Position | Dinesh S Mantri (PRESIDENT) |
| Authorized Official Contact | 5307684052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shasta Internal Medicine A Medical Corporation Po Box 991947 Redding CA 96099-1947 Ph: (530) 768-4052 | Shasta Internal Medicine A Medical Corporation 3760 Sunlight Ct Redding CA 96001-0173 Ph: (530) 768-4052 |
| NPI Number | 1134268444 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 8325002090 |
|---|---|
| Medicare Enrollment ID | O20041112001217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134268444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Dinesh Samaya Mantri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659411361 PECOS PAC ID: 4385628965 Enrollment ID: I20110401000536 |
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