Fmcps Santa Rosa LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

FMCPS SANTA ROSA LLC

Practice address

435 Doyle Park Dr
Santa Rosa, CA 95405-4515

Phone

(707) 527-9510

Fax

(602) 798-8267

NPI assigned

Nov 19, 2015

Organization subpart

No

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

Authorized official

Name

Pamela Young

Title

Corporate VP

Phone

(480) 639-7185

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1881068443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 W HAPPY VALLEY RD",
            "address_2": "SUITE 141-120",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853103289",
            "telephone_number": "844-540-8736",
            "fax_number": "602-798-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 DOYLE PARK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054515",
            "telephone_number": "707-527-9510",
            "fax_number": "602-798-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMCPS SANTA ROSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CORPORATE VP",
        "authorized_official_telephone_number": "480-639-7185"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.