Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glen S O'Sullivan, MD

Individual provider Specialist · NPI 1972504652

Glen S O'Sullivan, MD is an Orthopedic Surgery in Mount Shasta, California. Qualified in 1986, 40 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
40
Licensed in
CA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

635 Lassen Ln
Mount Shasta, CA 96067-9003
Phone: (866) 668-3597
Fax: (866) 301-6641
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence A44219 (CA)

Record details

NPI number1972504652
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 3, 2005
Last updated in NPPESNovember 23, 2010
Mailing address635 Lassen Ln, Mount Shasta, CA 96067-9003

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolOTHER
Graduated 1986 (40 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Mount Shasta