Individual provider · Type 1 NPI

Glen S. O'Sullivan, MD

Specialist · Mount Shasta, CA

NPI number 1972504652 Active

Practice location

635 Lassen Ln
Mount Shasta, CA 96067-9003

Fax (866) 301-6641

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XA44219 (CA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

4 other providers at this address

About NPI 1972504652

Glen S. O'Sullivan, MD's National Provider Identifier is 1972504652, issued on Aug 3, 2005. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Mount Shasta, CA. The record was last updated on Nov 23, 2010.