Holst, David Glenn

Holst, David Glenn is an individual health care provider with primary practice located at 824 Pine St , Mount Shasta CA 96067-2137. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Holst, David Glenn can be contacted via phone (530) 926-4528.

Contact Information

Primary practice address
824 Pine St Mount Shasta CA 96067-2137
Phone: (530) 926-4528
Fax: (530) 926-5070
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G76027 California
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X G76027 California

Profile Details

NPI number 1164416764
LBN Legal business name Holst, David Glenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 9th, 2005
Last updated Sep 19th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164416764 NPPES
Other 080080840 RAILROAD MEDICARE
MEDICAID 00G760270 RAILROAD MEDICARE

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