Organization
COAST GUARD TRAINING CENTER PETALUMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERRY RODRIGUEZ (CLINIC ADMINISTRATOR)
(707) 765-7200
Entity
Organization
Contact information
Practice address
599 TOMALES RD, HEALTH SERVICES DIVISION, PETALUMA, CA 94952-5002
(707) 765-7200
(707) 765-7521
Mailing address
599 TOMALES RD, HEALTH SERVICES DIVISION, PETALUMA, CA 94952-5002
(707) 765-7200
(707) 765-7521
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
CA
Other
Enumeration date
12/21/2006
Last updated
05/07/2009
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