Greenbriar Emergency Physicians Medical Group, Inc.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

GREENBRIAR EMERGENCY PHYSICIANS MEDICAL GROUP, INC.

Practice address

501 Petaluma Ave
Sebastopol, CA 95472-4215

Phone

(707) 823-8511

NPI assigned

Jan 25, 2016

Organization subpart

No

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

Authorized official

Name

Steven Maron, M.D.

Title

President

Phone

(925) 482-8249

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498089600000",
    "number": "1770940561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3098",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917737098",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PETALUMA AVE",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724215",
            "telephone_number": "707-823-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENBRIAR EMERGENCY PHYSICIANS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2017-06-22",
        "status": "A",
        "authorized_official_last_name": "MARON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-482-8249",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770940561",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; 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.