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SANTA ROSA VEIN ASSOCIATES INC NPI 1144764523


NPI Information

NPI: 1144764523
Provider Name: SANTA ROSA VEIN ASSOCIATES, INC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 05D1056268

Address:
990 SONOMA AVE
SUITE 2
SANTA ROSA, CA
ZIP 95404
Phone: (707) 636-8346
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SANTA ROSA VEIN ASSOCIATES, INC is a cardiovascular disease internal medicine in Santa Rosa, CA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. SANTA ROSA VEIN ASSOCIATES, INC NPI is 1144764523. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

990 SONOMA AVE
SUITE 2
SANTA ROSA, CA
ZIP 95404-813
Phone: (707) 636-8346
Fax: (707) 205-1008

The provider's authorized official is John J Hunter .
The authorized official title is President and has the following contact phone number (707) 527-8444.

The CLIA number assigned to this NPI record is 05D1056268 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/5/2016 and was last updated on 8/18/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RC0000XInternal MedicineCardiovascular DiseaseYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0065700MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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