Organization
REDWOOD REGIONAL MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE D HAYES (CHIEF OPERATING OFFICER)
(707) 525-6691
Entity
Organization
Contact information
Practice address
3555 ROUND BARN CIR, SANTA ROSA, CA 95403-1757
(707) 525-6124
(707) 525-4093
Mailing address
121 SOTOYOME ST, SANTA ROSA, CA 95405-4823
(707) 525-6124
(707) 525-4093
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
291U00000X
Clinical Medical Laboratory
05D0612494
CA
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0049201
—
CA
05
—
ZZZ83873Z
—
CA
Enumeration date
07/26/2006
Last updated
02/11/2014
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