Shasta ENT Specialists

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

SHASTA ENT SPECIALISTS

Practice address

2125 Court St
Redding, CA 96001-2531

Phone

(530) 242-5600

Fax

(530) 242-5605

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. George H Domb, MDNPI 1962426833

Title

Owner

Phone

(530) 242-5600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George H Domb, M.D.

  • Otolaryngology Physician
  • Redding, CA
  • NPI 1962426833
  Medicare reassignment NPD Authorized official
• Robert V Spake, M.D.

  • Otolaryngology Physician
  • Kansas City, MO
  • NPI 1932160942
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1801817929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 COURT ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012531",
            "telephone_number": "530-242-5600",
            "fax_number": "530-242-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 COURT ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012531",
            "telephone_number": "530-242-5600",
            "fax_number": "530-242-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHASTA ENT SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "DOMB",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-242-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shasta County Rehab LLC
• Shasta County Young Men's Christian Association (Shasta Family YMCA)
• Shasta Critical Care Specialists Medical Clinic, Inc.
• Shasta Emergency Medical Associates Inc
• Shasta Emergency Medical Group
• Shasta Eye Medical Group Inc (Larkspur Optometry)
• Shasta Eye Surgeons Inc (Surgery Center of Northern California)
• Shasta Hearing AIDS
• Shasta Heart Partners Inc
• Shasta Integrative Health

• Otolaryngology Physician in Redding, CA
• Providers in Redding, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.