Individual
RAYMOND EDWARD ERNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
719 SOUTHPOINT BLVD, STE B, PETALUMA, CA 94954-1495
(707) 778-8421
(707) 778-1702
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 585-6049
(707) 778-1702
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G52583
CA
207RI0011X
Interventional Cardiology Physician
G52583
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G525830
BLUE SHIELD OF CALIFORNIA
CA
05
—
00G525830
—
CA
01
—
060014838
RAILROAD MEDICARE
CA
Enumeration date
07/13/2005
Last updated
02/07/2012
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