Organization
COL NORTH CALIFORNIA, LLC
Active
Other names
Petaluma Open MRI
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK G. HOWARD (MANAGING MEMBER)
(337) 291-9161
Entity
Organization
Contact information
Practice address
181 LYNCH CREEK WAY, SUITE 102, PETALUMA, CA 94954-2372
(707) 766-7074
(707) 766-7075
Mailing address
181 LYNCH CREEK WAY, SUITE 102, PETALUMA, CA 94954-2372
(707) 766-7074
(707) 766-7075
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR004920D
—
CA
Enumeration date
07/15/2005
Last updated
03/03/2015
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