Organization
ANNADEL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOB JUST (COO)
(707) 303-8307
Entity
Organization
Contact information
Practice address
1165 MONTGOMERY DR, SANTA ROSA, CA 95405-4801
(707) 303-8307
(707) 303-1992
Mailing address
1165 MONTGOMERY DR, SANTA ROSA, CA 95405-4801
(707) 303-8307
(707) 303-1992
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G22056
CA
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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