Organization
NOVAMED SURGERY CENTER OF SANTA ROSA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT T. MACOMBER (EXECUTIVE VP & CFO)
(312) 780-3234
Entity
Organization
Contact information
Practice address
1720 4TH ST, SANTA ROSA, CA 95404-3602
(707) 546-8100
(707) 544-6438
Mailing address
1720 4TH ST, SANTA ROSA, CA 95404-3602
(707) 546-8100
(707) 544-6438
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
APPLIED FOR
CA
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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