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Contact Information

MOSSBRAE MEDICAL GROUP P.C.
234 GATEWAY PARK DR
MOUNT SHASTA, CA96067-9236
 Phone: 530-240-4855
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Emergency Medical Services

207PE0004X 93 Physician/Emergency Medicine
 

Home Health

251E00000X A4[11] Home Health Agency
 

Home Health

364SH0200X 89 Certified Clinical Nurse Specialist
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for MOSSBRAE MEDICAL GROUP P.C.

NPI Number 1619533072
LBN Legal business name MOSSBRAE MEDICAL GROUP P.C.
Authorized official AARON STUTZ - (CHIEF EXECUTIVE OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/11/2019
Last updated 12/24/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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