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Organization
PRIMARY CARE ASSOCIATES OF THE REDWOOD EMPIRE MEDICAL GROUP, INC.
Active
Organization
PRIMARY CARE ASSOCIATES OF THE REDWOOD EMPIRE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYMAN BOWEN GREAVES M.D. (PRESIDENT)
(707) 545-1300
Entity
Organization
Contact information
Practice address
500 DOYLE PARK DR, SUITE 200, SANTA ROSA, CA 95405-4558
(707) 545-1300
(707) 303-8304
Mailing address
500 DOYLE PARK DR, SUITE 200, SANTA ROSA, CA 95405-4558
(707) 545-1300
(707) 303-8304
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
CA
207Q00000X
Family Medicine Physician
Primary
—
CA
208000000X
Pediatrics Physician
—
CA
208M00000X
Hospitalist Physician
—
CA
363LF0000X
Family Nurse Practitioner
—
CA
363LP0200X
Pediatric Nurse Practitioner
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0061380
—
CA
05
—
GR0061381
—
CA
05
—
GR0061382
—
CA
05
—
GR0061383
—
CA
Enumeration date
08/25/2006
Last updated
06/21/2018
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