MOSSBRAE MEDICAL GROUP P.C. (NPI# 1619533072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619533072 |
| Entity Type | Organization |
| Organization Name | MOSSBRAE MEDICAL GROUP P.C. |
| Practice Address |
234 Gateway Park Dr. Mount Shasta CA 96067 |
| Mailing Address |
Po Box 239 Mount Shasta CA 96067-0239 |
| Practice Telephone | 5302404855 |
| Mailing Telephone | 5306055046 |
| Enumeration Date | 2019-05-11 |
| Last Update Date | 2019-08-06 |
| Authorized Official Name | DR. AARON STUTZ (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5306055046 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5727 Dunsmuir Ave, Dunsmuir, CA 960252008 | 5306055046 |
| Street Address |
234 GATEWAY PARK DR. |
| City | MOUNT SHASTA |
| State | CA |
| Zip Code | 96067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174851901 | Aaron Michael Stutz | Emergency Medicine | 234 Gateway Park Dr., Mount Shasta, CA 96067 | 2009-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538786322 | Lynn Louise Lloyd | Acupuncturist | 522 E. Alma St, Mount Shasta, CA 96067 | 2020-06-29 |
| 1356971626 | Insight Wellness Institute | Clinic/Center | 1005 Ream Ave, Mount Shasta, CA 96067 | 2020-01-24 |
| 1720477052 | Mountain Medics Inc | Ambulance | 234 Gateway Park Drive, Mount Shasta, CA 96067 | 2015-01-09 |
| 1093120172 | Diana L Muncy | Counselor | 301 N Mount Shasta Blvd Ste 2, Mount Shasta, CA 96067 | 2014-06-26 |
| 1487875415 | Blanchard Leroy Foster Jr. | Marriage & Family Therapist | 110 W. Castle Street, Suite 100, Mount Shasta, CA 96067 | 2007-05-01 |
| 1699815639 | Sally Mcfall | Marriage & Family Therapist | 1180-b Mount Shasta Blvd, Mt Shasta, CA 96067 | 2007-02-07 |
| 1174672174 | Anna Klimaszewski | Marriage & Family Therapist | 425 Oakway Rd, Mt Shasta, CA 96067 | 2007-01-09 |
| 1548355969 | John Cunningham | Marriage & Family Therapist | 705 Pine St., Mt Shasta, CA 96067 | 2006-10-03 |
| 1245330844 | Jacqueline Wilkinson Gilbert-parker | Physician Assistant | 822 Pine Street, Mount Shasta, CA 96067 | 2006-09-24 |
| 1841307501 | John Warren Mcgaughey | Dentist | 326 N Mt Shasta Blvd, #4, Mt Shasta, CA 96067 | 2006-08-25 |
| Find all providers in zip 96067 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396209086 | Michael Staszel D.o. P.a | Clinic/Center | 822 Pine St, Mount Shasta, CA 96067-2137 | 2019-01-26 |
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| Find all providers with the same taxonomy | ||||
| City | MOUNT SHASTA |
| Zip Code | 96067 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.