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Organization
INTERNAL MEDICINE ASSOCIATES OF SANTA ROSA MEDICAL GROUP INC
Active
Organization
INTERNAL MEDICINE ASSOCIATES OF SANTA ROSA MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE N TUCKER MD (PRESIDENT)
(707) 544-3411
Entity
Organization
Contact information
Practice address
500 DOYLE PARK DR, G03, SANTA ROSA, CA 95405
(707) 544-3411
(707) 544-0834
Mailing address
500 DOYLE PARK DR, G03, SANTA ROSA, CA 95405
(707) 544-3411
(707) 544-0834
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ3211
RR MCR
—
05
—
GR0044960
—
CA
01
—
ZZZ058282
BCBS
—
Enumeration date
03/02/2006
Last updated
08/22/2020
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