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Organization
SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC.
Active
Organization
SANTA ROSA ORTHOPAEDIC MEDICAL GROUP, INC.
Active
Other names
Santa Rosa Orthopaedic Medical Group, Inc., Santa Rosa Orthopaedic Medical Group, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA BROPHY (PRACTICE MANAGER)
(707) 546-1922
Entity
Organization
Contact information
Practice address
167 LYNCH CREEK WAY, PETALUMA, CA 94954-2343
(707) 546-1922
Mailing address
1405 MONTGOMERY DR, SANTA ROSA, CA 95405-4557
(707) 546-1922
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
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
04/25/2019
Last updated
07/14/2023
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