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PETALUMA SPECIALTY CENTER LLC. NPI 1528576675


NPI Information

NPI: 1528576675
Provider Name: PETALUMA SPECIALTY CENTER, LLC.
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
1456 PROFESSIONAL DR STE 404
PETALUMA, CA
ZIP 94954
Phone: (707) 981-7995
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PETALUMA SPECIALTY CENTER, LLC. is an ambulatory surgical clinic center in Petaluma, CA. PETALUMA SPECIALTY CENTER, LLC. NPI is 1528576675. The provider is registered as an organization entity type.

The provider's business location address is:

1456 PROFESSIONAL DR STE 404
PETALUMA, CA
ZIP 94954-639
Phone: (707) 981-7995
Fax: (707) 981-7912

The provider's authorized official is Michael Ishu Yang .
The authorized official title is President and has the following contact phone number (707) 981-7995.

The enumeration date for this NPI number is 1/10/2018 and was last updated on 4/12/2018.


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
1261QA1903XClinic/CenterAmbulatory SurgicalCALIFORNIAYes

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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