Organization
SANTA ROSA HEAD AND NECK SURGICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID QUENELLE M.D. (PRESIDENT)
(707) 523-7025
Entity
Organization
Contact information
Practice address
2451 SUMMERFIELD RD, SANTA ROSA, CA 95405-7815
(707) 523-7025
(707) 591-0224
Mailing address
2451 SUMMERFIELD RD, SANTA ROSA, CA 95405-7815
(707) 523-7025
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0079030
—
CA
Enumeration date
06/12/2006
Last updated
08/22/2020
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