in Santa Rosa - Preferred Provider Organization

- NPI 1376752758

is a Preferred Provider Organization in Santa Rosa, California. practices all healthcare services and medical treatments related to Preferred Provider Organization. The NPI Number for is 1376752758. The last update date is .

's current location address is 1450 Neotomas Ave Ste 200, Santa Rosa, California. You can contact this provider via phone number 7075654861. The mailing address for is 1450 Neotomas Ave Ste 200, Santa Rosa, California. To know further, please read the information below!

Provider Profile Detail

Provider Name
Address 1450 Neotomas Ave Ste 200, Santa Rosa, California
Phone Number 7075654861
Fax Number
Sole Proprietor --
Credentials --

NPI Number Detail

NPI Number 1376752758
Provider Enumeration Date
Last Updated Date

Provider Mailing Address Detail

Address 1450 Neotomas Ave Ste 200
City Santa Rosa
State California (CA)
Post Code 954057574
Phone Number 7075654861
Fax Number

Provider's Primary Taxonomy Detail

Speciality Preferred Provider Organization
Taxonomy 305R00000X
Definition:
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient rec

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
4982 FFS MFT'S

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