Organization
BROOKWOOD INTERNAL MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE WOLFE (OFFICE MANAGER)
(707) 545-1700
Entity
Organization
Contact information
Practice address
500 DOYLE PARK DR, STE. 304, SANTA ROSA, CA 95405-4558
(707) 545-1700
(707) 579-1958
Mailing address
500 DOYLE PARK DR, STE. 304, SANTA ROSA, CA 95405-4558
(707) 545-1700
(707) 579-1958
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0066470
—
CA
Enumeration date
04/03/2006
Last updated
08/22/2020
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