# JAMES E O'DORISIO MD A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083050041
- **Authorized official:** JAMES E. O'DORISIO MD (OWNER)
- **Authorized official phone:** (707) 578-3000

## Contact information

- **Practice address:** 76 BROOKWOOD AVE, SANTA ROSA, CA 95404-4312
- **Practice address phone:** (707) 578-3000
- **Practice address fax:** (707) 540-6407
- **Mailing address:** 76 BROOKWOOD AVE, SANTA ROSA, CA 95404-4312
- **Mailing address phone:** (707) 578-3000
- **Mailing address fax:** (707) 540-6407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | A44147 | CA | Yes |

## Other

- **Enumeration date:** 05/17/2013
- **Last updated:** 08/11/2015