NPI Provider: 1972683654
Contact Name: Faust Logan Robert
Position: MD Director
Phone: (707) 544-5093
Santa Rosa Gastroenterology Med Assoc Inc Information:
Santa Rosa Gastroenterology Med Assoc Inc organization have npi 1972683654, taxonomy code is 207RG0100X with license number is in . This Business address located in 1210 Sonoma Ave, Santa Rosa, CA 95405 California.
Practice Location
Address: 1210 Sonoma Ave, Santa Rosa, CA 95405
Phone: (707) 544-5093
Business Location
Address: 1210 Sonoma Ave, Santa Rosa, CA 95405
Phone: (707) 544-5093
Fax: (707) 528-8444
Taxonomy
Taxonomy Code: 207RG0100X
License Number:
License Number of State:
Primary Taxonomy Switch: Y
Enumeration Date: 10/16/2006
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