Organization
SANTA CRUZ PULMONARY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REGINA AUDREY ANYANG (BUSINESS MANAGER)
(831) 425-1906
Entity
Organization
Contact information
Practice address
700 FREDERICK ST, SUITE 203, SANTA CRUZ, CA 95062-2239
(831) 425-1906
(831) 425-1922
Mailing address
700 FREDERICK ST, SUITE 203, SANTA CRUZ, CA 95062-2239
(831) 425-1906
(831) 425-1922
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0056730
—
CA
Enumeration date
07/17/2006
Last updated
02/17/2010
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