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Organization

SANTA ROSA GASTROENTEROLOGY MEDICAL ASSOCIATES

Active
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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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