Petaluma Surgicenter

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

110000263 Issued in CA

Legal business name

PETALUMA SURGICENTER

Practice address

1400 Professional Dr
Suite 102
Petaluma, CA 94954-5110

Phone

(707) 763-9325

Fax

(707) 769-0751

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Ronald Lavigna, DPM

Title

Owner

Phone

(707) 763-9325

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1326259276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 PROFESSIONAL DR",
            "address_2": "SUITE 102",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949545110",
            "telephone_number": "707-763-9325",
            "fax_number": "707-769-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PROFESSIONAL DR",
            "address_2": "SUITE 102",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949545110",
            "telephone_number": "707-763-9325",
            "fax_number": "707-769-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETALUMA SURGICENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "LAVIGNA",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-763-9325",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "CA",
            "license": "110000263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Petaluma People Services Center
• Petaluma Physical Therapy Associates Inc
• Petaluma Skilled Nursing & Wellness Centre, LLC
• Petaluma SNF Healthcare, LLC
• Petaluma Specialty Center, LLC.
• Petaluma Taxi Services LLC
• Petaluma Tracen Uscg Phcy
• Petaluma Valley Dental
• Petaluma Valley Hearing Center
• Petalumaidence Opco, LLC

• Podiatric Clinic/Center in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Podiatric Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.