Redwood Pediatric Medical Group in Fortuna - Specialist
Redwood Pediatric Medical Group - NPI 1164574083
Redwood Pediatric Medical Group is a Specialist in Fortuna, California. Redwood Pediatric Medical Group practices all healthcare services and medical treatments related to Specialist. The NPI Number for Redwood Pediatric Medical Group is 1164574083. The last update date is 2020-08-22.
Redwood Pediatric Medical Group's current location address is 3305 Renner Dr, Fortuna, California. You can contact this provider via phone number 7077259355 and fax number 7077252426. The mailing address for Redwood Pediatric Medical Group is 3305 Renner Dr, Fortuna, California. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Redwood Pediatric Medical Group |
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Address | 3305 Renner Dr, Fortuna, California |
Phone Number | 7077259355 |
Fax Number | 7077252426 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | BILLING MA |
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Authorized Official Name | Ivey Shalamar |
Telephone Number | 7077259355 |
NPI Number Detail
NPI Number | 1164574083 |
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Provider Enumeration Date | 2007-01-18 |
Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
Address | 3305 Renner Dr |
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City | Fortuna |
State | California (CA) |
Post Code | 955403119 |
Phone Number | 7077259355 |
Fax Number | 7077252426 |
Provider's Primary Taxonomy Detail
Speciality | Specialist |
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Taxonomy | 174400000X |
Licence No | G082256 |
Definition: 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. |
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What is the Redwood Pediatric Medical Group's 1164574083?
The Redwood Pediatric Medical Group's NPI (National Provider Identifier) Number is 1164574083. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Redwood Pediatric Medical Group?
The Redwood Pediatric Medical Group is situated at 3305 Renner Dr, in the city of Fortuna, state of CA, with the zip code 955403119.
What is Redwood Pediatric Medical Group's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Redwood Pediatric Medical Group is Specialist, and the taxonomy code that classifies this field of practice is 174400000X.
On what date did Redwood Pediatric Medical Group receive its 1164574083 assignment from the Centers for Medicare & Medicaid Services?
The Redwood Pediatric Medical Group was assigned its 1164574083 on 2007-01-18, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Redwood Pediatric Medical Group most recently updated or revised?
The details related to Redwood Pediatric Medical Group, including its address, specialty, and other relevant information, were last updated or revised on 2020-08-22.
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