Organization
REDWOOD MEMORIAL HOSPITAL
Active
Other names
REDWOOD MEMORIAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE ROGERS (COO)
(707) 725-3361
Entity
Organization
Contact information
Practice address
3300 RENNER DR, FORTUNA, CA 95540-3120
(707) 725-3361
(707) 725-7212
Mailing address
3300 RENNER DR, FORTUNA, CA 95540-3120
(707) 725-3361
(707) 725-7212
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051318
MEDICARE
CA
05
—
HSP40172F
—
CA
Enumeration date
08/07/2007
Last updated
08/07/2007
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