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
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | A44219 (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
- Julie Conyers MD IncSurgery Physician Mount Shasta, CA NPI 1730436007
- Peter Grant MDPhysical Medicine & Rehabilitation Physician Mount Shasta, CA NPI 1841483732
- Todd Guthrie, M.d., Professional CorporationOrthopaedic Surgery Physician Mount Shasta, CA NPI 1639366784
- Todd Guthrie, MDOrthopaedic Surgery Physician Mount Shasta, CA NPI 1871555334
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.