Organization Name: | LASSEN MEDICAL CENTER |
NPI Number: | 1750413597 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TONYA JOYNER (OFFICE TECH) |
Mailing Address: | 103 Fair Dr Susanville |
State: | CA US |
Postal Code: | 961304201 |
Phone Number: | 5302577773 |
Fax Number: | 5302572939 |
NPI Enumeration Date: | 03/09/2007 |
NPI Last Update Date: | 02/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A35254 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |