Organization Name: | BROOKWOOD INTERNAL MEDICAL ASSOCIATES, INC. |
NPI Number: | 1588626832 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANE WOLFE (OFFICE MANAGER) |
Mailing Address: | 500 Doyle Park Dr Ste. 304 Santa Rosa |
State: | CA US |
Postal Code: | 954054558 |
Phone Number: | 7075451700 |
Fax Number: | 7075791958 |
NPI Enumeration Date: | 04/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |