Internal Medicine Associates Of Santa Rosa Medical Group Inc

LBN: Internal Medicine Associates Of Santa Rosa Medical Group Inc
Internal Medicine Associates Of Santa Rosa Medical Group Inc is an health care organization with primary practice located at 500 Doyle Park Dr G03, Santa Rosa CA 95405. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Internal Medicine Associates Of Santa Rosa Medical Group Inc can be contacted via phone (707) 544-3411, or through Tucker, Bruce N via phone (707) 544-3411.

Contact Information

Primary practice address
500 Doyle Park Dr G03 Santa Rosa CA 95405
Fax: (707) 544-0834
Website:
Authorized official contact:
Name: Tucker, Bruce N Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X

Profile Details

NPI number 1548237175
LBN Legal business name Internal Medicine Associates Of Santa Rosa Medical Group Inc
DBA Doing business as
Authorized official Tucker, Bruce N Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 2nd, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548237175 NPPES
Other CJ3211 RR MCR
MEDICAID GR0044960 RR MCR
Other ZZZ058282 RR MCR

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