Lake Shastina Medical Clinic INC
NPI #1356331615 in Weed, California
Provider Information
- NPI Number
- 1356331615
- Entity Type
- Organization
- Organization Name
- Lake Shastina Medical Clinic INC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Oct 26, 2005
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 16337 EVERHART DR
- City
- Weed
- State
- California
- ZIP Code
- 96094-9400
- Phone
- (530) 938-2297
Authorized Official
- Name
- DR. PHILLIP M MILLER, M.D.
- Title
- CEO
- Phone
- (530) 938-2297
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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