Organization Active NPI

Sutter Medical Group of the Redwoods

  • Pediatrics Physician
  • Santa Rosa, CA
National Provider Identifier
1760638449
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SUTTER MEDICAL GROUP OF THE REDWOODS
Practice address
255 Farmers LN
Santa Rosa, CA 95405-4721
Phone
(707) 545-2255
NPI assigned
Aug 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Dr. Steven E Levenberg, D.O.
Title
President
Phone
(707) 521-8879

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

255 Farmers LN
Santa Rosa, CA 95405-4721

Mailing address

3883 Airway Dr
300
Santa Rosa, CA 95403-1670
Phone (707) 521-8809

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1760638449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR",
            "address_2": "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": "255 FARMERS LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054721",
            "telephone_number": "707-545-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUTTER MEDICAL GROUP OF THE REDWOODS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2008-08-13",
        "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": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "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, 2008; 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.