Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Lake Shastina Medical Clinic Inc

Organization Family Medicine Physician · NPI 1356331615

Lake Shastina Medical Clinic Inc provides Family Medicine Physician services in Weed, California. Registered with an NPI since 2005.

In the registry since
2005
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

16337 Everhart Dr
Weed, CA 96094-9400
Phone: (530) 938-2297
Fax: (530) 938-0494
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1356331615
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Phillip Miller — Ceo · (530) 938-2297
NPI enumeratedOctober 26, 2005
Last updated in NPPESAugust 22, 2020
Mailing address16337 Everhart Dr, Weed, CA 96094-9400

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