Organization
SANTA ROSA GASTROENTEROLOGY MEDICAL ASSOCIATES
Active
Other names
SRGMA Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LOGAN FAUST MD (MD DIRECTOR)
(707) 544-5093
Entity
Organization
Contact information
Practice address
1210 SONOMA AVE, SUITE B, SANTA ROSA, CA 95405
(707) 544-5093
(707) 528-8444
Mailing address
1210 SONOMA AVE, SUITE B, SANTA ROSA, CA 95405
(707) 544-5093
(707) 528-8444
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0101070
—
CA
Enumeration date
10/16/2006
Last updated
10/01/2008
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