North Coast Faculty Medical Group Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

NORTH COAST FACULTY MEDICAL GROUP INC

Practice address

555 Petaluma Ave
Sebastopol, CA 95472-4224

Phone

(707) 829-8426

Fax

(707) 829-6675

NPI assigned

Aug 25, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Steven E Levenberg, DO

Title

President

Phone

(707) 521-8879

Specialties & licenses 2

Addresses

Other names 1

• Sutter Medical Group of the Redwoods Doing business as

Locations

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255651200000",
    "number": "1710110754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR",
            "address_2": "SUITE 300",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031670",
            "telephone_number": "707-521-8809",
            "fax_number": "707-521-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 PETALUMA AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724224",
            "telephone_number": "707-829-8426",
            "fax_number": "707-829-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COAST FACULTY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-10-16",
        "status": "A",
        "authorized_official_last_name": "LEVENBERG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-521-8879",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Medical Group of the Redwoods",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Larry Minoru Nakashima, D.D.S.
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• Anna Eraquin Nelson, ASW
• Nicholas Giardino PHD Psychology PC
• Kerry Niemann, RN
• North Coast Faculty Medical Group Inc
• Northern California Medical Assoc Inc
• Northern California Medical Assoc Inc
• Flannery Norton, MA, PPS
• Nicole Helene O'Brien, MA, LMFT

• Surgery Physician in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2009; 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.