Pacific Redwood Medical Group Inc

LBN: Pacific Redwood Medical Group Inc
Pacific Redwood Medical Group Inc is an health care organization with primary practice located at 275 Hospital Dr , Ukiah CA 95482. The organization recently has 8 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Emergency Medicine is the primary health care specialty. Pacific Redwood Medical Group Inc can be contacted via phone (707) 462-7900, or through Fausone, Gary W via phone (707) 462-7900.

Contact Information

Primary practice address
275 Hospital Dr Ukiah CA 95482
Phone: (707) 462-7900
Fax: (707) 462-7947
Website:
Map and Directions
Authorized official contact:
Name: Fausone, Gary W Doctor of Medicine (MD)
Phone: (707) 462-7900

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X
Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine 2083P0500X
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X

Profile Details

NPI number 1033103676
LBN Legal business name Pacific Redwood Medical Group Inc
DBA Doing business as
Authorized official Fausone, Gary W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 9th, 2005
Last updated Jul 31st, 2018 - about 6 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 1033103676 NPPES
California Other 17165692005 STATE COMPENSATION INS
California MEDICAID GR0093400 STATE COMPENSATION INS
California Other 352149100 STATE COMPENSATION INS
California Other ZZZ06060Z STATE COMPENSATION INS

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