| Spine And Neurosurgical Trauma Associates Of Northern California | |
|
4690 Hoen Ave Santa Rosa CA 95405-7823 | |
| (707) 799-5911 | |
| Not Available |
| Full Name | Spine And Neurosurgical Trauma Associates Of Northern California |
|---|---|
| Speciality | Neurological Surgery |
| Location | 4690 Hoen Ave, Santa Rosa, California |
| Authorized Official Name and Position | Scott Glickman (PRESIDENT) |
| Authorized Official Contact | 7077995911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spine And Neurosurgical Trauma Associates Of Northern California 1275 4th St Pmb 646 Santa Rosa CA 95404-4057 Ph: (707) 799-5911 | Spine And Neurosurgical Trauma Associates Of Northern California 4690 Hoen Ave Santa Rosa CA 95405-7823 Ph: (707) 799-5911 |
| NPI Number | 1174925697 |
|---|---|
| Provider Enumeration Date | 09/17/2014 |
| Last Update Date | 09/17/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174925697 | NPI | - | NPPES |
| 3102403 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084V0102X | Psychiatry & Neurology - Vascular Neurology | 13305 (California) | Secondary |
| 207T00000X | Neurological Surgery | 13305 (California) | Primary |
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