SISKIYOU PROFESSIONAL MEDICAL SERVICE, PROF. CORP. (NPI# 1700028560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700028560 |
| Entity Type | Organization |
| Organization Name | SISKIYOU PROFESSIONAL MEDICAL SERVICE, PROF. CORP. |
| Practice Address |
6736 Quail Run Road Yreka CA 96097-3540 |
| Mailing Address |
P.o. Box 1667 Yreka CA 96097-3450 |
| Practice Telephone | 5308422800 |
| Mailing Telephone | 5308422800 |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |
| Authorized Official Name | DR. ARVID R. MAGNUSON (PRESIDENT) |
| Authorized Official Telephone | 5308422800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Street Address |
6736 QUAIL RUN ROAD |
| City | YREKA |
| State | CA |
| Zip Code | 96097-3540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376830653 | Paul William Willis | Pharmacist | 807 S. Main St., Yreka, CA 96097 | 2011-07-07 |
| 1578883864 | Ginger A Bert | Chiropractor | 106 Ranch Ln Ste A, Yreka, CA 96097 | 2010-06-09 |
| 1669796611 | Rebekah Joyce Retterath | Dietitian, Registered | 444 Bruce Street, Yreka, CA 96097 | 2010-03-19 |
| 1780849679 | Donna Jean May | Marriage & Family Therapist | 625 Butte Street, Yreka, CA 96097 | 2008-07-21 |
| 1114121589 | Loren Cronk | Marriage & Family Therapist | 208 4th Street, Yreka, CA 96097 | 2007-06-12 |
| 1093928863 | Kristin Rene Kopplin | Psychologist | 1515 South Oregon Street, Suite A, Yreka, CA 96097 | 2007-05-08 |
| 1073735379 | Rivkah Lynn Barmore | Social Worker | 1515 S Oregon, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1649492091 | Randy Terry Murieen | Social Worker | 1515 S Oregon Street, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1265654537 | Roy Victor Hall Jr. | Social Worker | 1515 South Oregon St, Suite A, Yreka, CA 96097 | 2007-05-03 |
| 1578785614 | Meadowlark | Assisted Living Facility | 351 Bruce St, Yreka, CA 96097 | 2007-05-02 |
| Find all providers in zip 96097 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124194584 | Robert A Carter | Urology | 200 North Main Street, Yreka, CA 96097 | 2006-11-28 |
| 1326016692 | Robert A Carter Md Inc | Urology | 200 No Main Street, Yreka, CA 96097 | 2006-03-10 |
| 1629033535 | Saekyu Robert Kim | Urology | 475 Bruce St, Yreka, CA 96097-3474 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033096 | Urology Surgical Partners | Urology | 15944 Los Serranos Country Club Dr Ste 200, Chino Hills, CA 91709-3991 | 2020-11-06 |
| 1891301487 | Fadl Hamouche | Urology | 400 Parnassus Ave # A632, San Francisco, CA 94143-2202 | 2020-09-18 |
| 1083233902 | Elite Medical Group PC | Urology | 2083 Compton Ave Ste 202, Corona, CA 92881-3416 | 2020-04-10 |
| 1659919660 | Thrive Medical, Inc. | Urology | 18740 Ventura Blvd Ste 101, Tarzana, CA 91356-3366 | 2019-12-20 |
| 1457997645 | David G Song Md Inc | Urology | 5365 Walnut Avenue Ste A, Chino, CA 91710-9171 | 2019-11-21 |
| 1699316273 | Golden Gate Urology Inc | Urology | 929 Clay St Ste 505, San Francisco, CA 94108-1500 | 2019-10-04 |
| 1598318461 | Khoddami Medical Group Inc | Urology | 2705 Loma Vista Rd Ste 206, Ventura, CA 93003-1584 | 2019-07-19 |
| 1942760293 | Adventist Health Physicians Network | Urology | 2701 Chester Ave # 102, Bakersfield, CA 93301-2016 | 2019-03-22 |
| 1699233361 | Orange Coast Medical, A Medical Corporation | Urology | 10900 Warner Ave Ste 121, Fountain Valley, CA 92708-3846 | 2019-03-12 |
| 1891268389 | John Joseph Granato Jr. | Urology | 333 Cumberland Rd, Glendale, CA 91202-1256 | 2019-01-07 |
| Find all providers with the same taxonomy | ||||
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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.