Organization
EEL RIVER VALLEY SURGICAL GROUP
Active
Other names
Eel River Valley Surgical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN T HASSAPIS MD (CEO)
(707) 725-9301
Entity
Organization
Contact information
Practice address
3301 RENNER DR, FORTUNA, CA 95540-3119
(707) 725-9301
(707) 725-6099
Mailing address
3301 RENNER DR, FORTUNA, CA 95540-3119
(707) 725-9301
(707) 725-6099
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0082870
—
CA
01
—
ZZZ56802Z
BLUE SHIELD GROUP ID
CA
Enumeration date
01/19/2007
Last updated
08/22/2020
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