ANNADEL MEDICAL GROUP NPI 1740602309

NPI Information

  • NPI: 1740602309
  • Provider Name: ANNADEL MEDICAL GROUP
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 1165 MONTGOMERY DR
    SANTA ROSA, CA
    ZIP 95405
  • Phone: (707) 303-8307

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NPI Details

ANNADEL MEDICAL GROUP is a specialist in Santa Rosa, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ANNADEL MEDICAL GROUP NPI is 1740602309. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1165 MONTGOMERY DR
SANTA ROSA, CA
ZIP 95405-801
Phone: (707) 303-8307
Fax: (707) 303-1992

The provider's authorized official is Bob Just .
The authorized official title is Coo and has the following contact phone number (707) 303-8307.

The enumeration date for this NPI number is 1/15/2014 and was last updated on 1/15/2014.

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
1174400000XSpecialistG22056CALIFORNIAYes

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: 11/21/2025

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