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ALLERGY & ASTHMA ADULT & PEDIATRIC MEDICAL GROUP OF THE REDWOODS INC NPI 1730257932


NPI Information

NPI: 1730257932
Provider Name: ALLERGY & ASTHMA ADULT & PEDIATRIC MEDICAL GROUP OF THE REDWOODS INC

Doing Business As: FAMILYCARE ALLERGY AND ASTHMA

Classification: Allergy & Immunology - 207K00000X
Entity Type: Organization
Address:
130 STONY POINT RD
SUITE E
SANTA ROSA, CA
ZIP 95401
Phone: (707) 525-0211
Get Directions

ALLERGY & ASTHMA ADULT & PEDIATRIC MEDICAL GROUP OF THE REDWOODS INC is an allergy immunology in Santa Rosa, CA. The provider is an allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. ALLERGY & ASTHMA ADULT & PEDIATRIC MEDICAL GROUP OF THE REDWOODS INC NPI is 1730257932. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Familycare Allergy And Asthma.

The provider's business location address is:

130 STONY POINT RD
SUITE E
SANTA ROSA, CA
ZIP 95401-120
Phone: (707) 525-0211
Fax: (707) 525-0491

The provider's authorized official is John F Petrick .
The authorized official title is Ceo and has the following contact phone number (707) 525-0211.

The enumeration date for this NPI number is 12/4/2006 and was last updated on 11/16/2015.


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
1207KI0005XAllergy & ImmunologyClinical & Laboratory ImmunologyG29076CALIFORNIANo
2207KI0005XAllergy & ImmunologyClinical & Laboratory ImmunologyG33461CALIFORNIANo
3207K00000XAllergy & ImmunologyC132754CALIFORNIAYes

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
1E24854MEDICARE UPIN
2HKRAA3F00OTHERHIN NUMBER
3GR0061440MEDICAIDCALIFORNIA
4A45560MEDICARE UPIN
5ZZZ95243ZOTHERCALIFORNIAMEDICARE PTAN

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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