Organization
NORTH BAY CARDIOLOGY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN WAYNE HALPERN MD (PRESIDENT)
(707) 542-2783
Entity
Organization
Contact information
Practice address
4740 HOEN AVE, SANTA ROSA, CA 95405-7824
(707) 542-2783
(707) 542-7976
Mailing address
4740 HOEN AVE, SANTA ROSA, CA 95405-7824
(707) 542-2783
(707) 542-7976
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0091060
—
CA
01
—
ZZZ17933Z
MEDICARE ID TYPE UNSPECIFIED
CA
Enumeration date
11/15/2006
Last updated
11/18/2009
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