Organization Active NPI

Primecare Medical Group, Inc.

  • Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1255256491
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PRIMECARE MEDICAL GROUP, INC.
Practice address
100 E St Ste 301
Santa Rosa, CA 95404-4607
Phone
(369) 208-7688
Fax
(369) 208-7674
NPI assigned
Aug 13, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Anthony Ogugu
Title
Ceo
Phone
(369) 208-7688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

100 E St Ste 301
Santa Rosa, CA 95404-4607

Mailing address

100 E St Ste 301
Santa Rosa, CA 95404-4607
Phone (369) 208-7688

National Provider Directory

National Provider Directory

Locations

100 E St
Ste 301
Santa Rosa, CA 95404

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1786579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1255256491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E ST STE 301",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044607",
            "telephone_number": "369-208-7688",
            "fax_number": "369-208-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E ST STE 301",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044607",
            "telephone_number": "369-208-7688",
            "fax_number": "369-208-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-13",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "OGUGU",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "369-208-7688"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.