SANTA ROSA SURGICAL SERVICES LLC NPI 1497407894

NPI Information

NPI: 1497407894
Provider Name: SANTA ROSA SURGICAL SERVICES LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 05D2275213

Address:
1739 4TH ST
SANTA ROSA, CA
ZIP 95404
Phone: (707) 931-5599
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SANTA ROSA SURGICAL SERVICES LLC is an ambulatory surgical clinic center in Santa Rosa, CA. SANTA ROSA SURGICAL SERVICES LLC NPI is 1497407894. The provider is registered as an organization entity type.

The provider's business location address is:

1739 4TH ST
SANTA ROSA, CA
ZIP 95404-601
Phone: (707) 931-5599
Fax: (707) 222-5099

The provider's authorized official is Eric Bruntlett .
The authorized official title is Administrator and has the following contact phone number (707) 495-9632.

The CLIA number assigned to this NPI record is 05D2275213 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2022 and was last updated on 11/4/2022.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

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

NPI Synchronization or Removal

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