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Organization
SANTA ROSA SURGICAL ASSOCIATES
Active
Organization
SANTA ROSA SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL WYCKOFF (OFFICE MANAGER)
(707) 579-2100
Entity
Organization
Contact information
Practice address
3536 MENDOCINO AVE, SUITE 250, SANTA ROSA, CA 95403-3634
(707) 579-2100
(707) 523-0616
Mailing address
3536 MENDOCINO AVE, SUITE 250, SANTA ROSA, CA 95403-3634
(707) 579-2100
(707) 523-0616
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/29/2006
Last updated
08/22/2020
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