| Department Of Health Services | |
|
155 N. Pythian Road Santa Rosa CA 95409 | |
| (707) 565-6350 | |
| Not Available |
| Full Name | Department Of Health Services |
|---|---|
| Speciality | Clinic/center |
| Location | 155 N. Pythian Road, Santa Rosa, California |
| Authorized Official Name and Position | Diana Stornetta (ACCOUNTANT III COMPLIANCE) |
| Authorized Official Contact | 7075654782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Department Of Health Services Po Box 1539 Santa Rosa CA 95402-1539 Ph: () - | Department Of Health Services 155 N. Pythian Road Santa Rosa CA 95409 Ph: (707) 565-6350 |
| NPI Number | 1114071453 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 12/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114071453 | NPI | - | NPPES |
| ZZR11473F | Other | CA | CALIFORNIA MEDI-CAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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