Organization
SANTA ROSA SURGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BRUNTLETT (ADMINISTRATOR)
(707) 495-9632
Entity
Organization
Contact information
Practice address
1739 4TH ST, SANTA ROSA, CA 95404-3601
(707) 931-5599
(707) 222-5099
Mailing address
1739 4TH ST, SANTA ROSA, CA 95404-3601
(707) 931-5599
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
11/04/2022
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