# SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Santa Rosa Orthopaedic Medical Group, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164637922
- **Authorized official:** ALICIA BROPHY (PRACTICE MANAGER)
- **Authorized official phone:** (707) 546-1922

## Contact information

- **Practice address:** 1405 MONTGOMERY DR, SANTA ROSA, CA 95405-4557
- **Practice address phone:** (707) 546-1922
- **Practice address fax:** (707) 546-1897
- **Mailing address:** 1405 MONTGOMERY DR, SANTA ROSA, CA 95405-4557
- **Mailing address phone:** (707) 546-1922
- **Mailing address fax:** (707) 546-1897

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | — | — |
| 207XX0801X | Orthopaedic Trauma Physician | — | NULL | — |
| 207XX0801X | Orthopaedic Trauma Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 05/14/2007
- **Last updated:** 07/14/2023