Siskiyou Professional Medical Service, Prof. Corp.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

SISKIYOU PROFESSIONAL MEDICAL SERVICE, PROF. CORP.

Practice address

6736 Quail Run Road
Yreka, CA 96097-3540

Phone

(530) 842-2800

NPI assigned

Mar 25, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Arvid R. Magnuson, M.D.

Title

President

Phone

(530) 842-2800

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1700028560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1667",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973450",
            "telephone_number": "530-842-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6736 QUAIL RUN ROAD",
            "city": "YREKA",
            "state": "CA",
            "postal_code": "960973540",
            "telephone_number": "530-842-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISKIYOU PROFESSIONAL MEDICAL SERVICE, PROF. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "MAGNUSON",
        "authorized_official_first_name": "ARVID",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-842-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Siskiyou Hospital Inc.
• Siskiyou Hospital, Inc.
• Siskiyou Hospital, Inc.
• Siskiyou Optical
• Siskiyou Pharmacy Services Inc
• Richard Slarve, M.D.
• Tari L Slizewski, LMFT
• Smart Siskiyou Medical Arts, Inc.
• Delores Smith
• Nicole Klaus Smith, DNP, RN, FNP-BC

• Urology Physician in Yreka, CA
• Providers in Yreka, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.