NORTH COAST FACULTY MEDICAL GROUP INC. (NPI# 1760717441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760717441 |
| Entity Type | Organization |
| Organization Name | NORTH COAST FACULTY MEDICAL GROUP INC. |
| Other Organization Name | SUTTER MEDICAL GROUP OF THE REDWOODS |
| Practice Address |
1144 Sonoma Ave 101 Santa Rosa CA 95405-4812 |
| Mailing Address |
3883 Airway Dr Suite 300 Santa Rosa CA 95403-1670 |
| Practice Telephone | 7075267920 |
| Practice Fax Number | 7075465334 |
| Mailing Telephone | 7075218809 |
| Mailing Fax Number | 7075218820 |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2009-10-13 |
| Authorized Official Name | DR. STEVEN E LEVENBERG (PRESIDENT) |
| Authorized Official Telephone | 7075218879 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sutter Medical Group of the Redwoods | Doing Business As Name - Organization |
| Street Address |
1144 SONOMA AVE 101 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-4812 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609866888 | Jeffrey D. Bean | Dentist | 1144 Sonoma Ave, St. 102, Santa Rosa, CA 95405-4812 | 2005-10-27 |
| 1952837155 | Dental Group of Emine Loxley, Dds, Inc | Clinic/Center | 1144 Sonoma Ave, #107, Santa Rosa, CA 95405-4812 | 2017-05-08 |
| 1407219355 | Tina Marie Kelly | Marriage & Family Therapist | 1144 Sonoma Ave, Suite 104, Santa Rosa, CA 95405-4812 | 2016-03-29 |
| 1033594783 | Edward A Biery | Psychologist | 1144 Sonoma Ave, Ste 104, Santa Rosa, CA 95405-4812 | 2015-07-23 |
| 1366820474 | Jennifer E. Blum | Psychologist | 1144 Sonoma Ave, 104, Santa Rosa, CA 95405-4812 | 2015-05-08 |
| 1467847103 | Rafael Miguel Diaz | Psychologist | 1144 Sonoma Ave, Suite 104, Santa Rosa, CA 95405-4812 | 2015-03-31 |
| 1518370519 | Dena Nicole Dimond | Nurse Practitioner | 1144 Sonoma Ave, Ste 119, Santa Rosa, CA 95405-4812 | 2014-06-06 |
| 1992123905 | Elizabeth Cassanos | Psychologist | 1144 Sonoma Ave, Santa Rosa, CA 95405-4812 | 2014-04-07 |
| 1679882880 | Dorothy Marie Mandel | Psychologist | 1144 Sonoma Ave, Ste 117, Santa Rosa, CA 95405-4812 | 2010-10-05 |
| 1225346398 | Tina Louise Sandoval-dyer | Marriage & Family Therapist | 1144 Sonoma Ave, Suite 117, Santa Rosa, CA 95405-4812 | 2010-09-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477528859 | Alexander J Lozano | Otolaryngology | 2025 Bent Tree Pl, Santa Rosa, CA 95404-1570 | 2006-02-21 |
| 1063486546 | Kim Elaine Schmitt | Otolaryngology | 1701 4th St Ste 120, Santa Rosa, CA 95404 | 2006-02-14 |
| 1205213170 | Annick Aubin-pouliot | Otolaryngology | 1701 4th St Ste 120, Santa Rosa, CA 95404-3661 | 2015-04-30 |
| 1982947404 | Elizabeth Debra Cedars | Otolaryngology | 1701 4th St Ste 120, Santa Rosa, CA 95404 | 2013-04-03 |
| 1023246089 | Anton Kushnaryov | Otolaryngology | 1701 4th St, Ste 120, Santa Rosa, CA 95404-3661 | 2009-06-30 |
| 1225203862 | Richard Turley | Otolaryngology | 401 Bicentennial Way, Santa Rosa, CA 95403-2149 | 2008-04-24 |
| 1699963231 | Stephanie Su Huang | Otolaryngology | 1701 4th St, Ste 120, Santa Rosa, CA 95404-3661 | 2007-10-09 |
| 1346315181 | Dr Jeff Broffman A Medical Corp | Otolaryngology | 1144 Sonoma Ave, #101, Santa Rosa, CA 95405 | 2006-11-21 |
| 1881773927 | Charles Daniel Sooy | Otolaryngology | 401 Bicentennial Way, Santa Rosa, CA 95403-2149 | 2006-11-02 |
| 1528146008 | Edward W. Chang | Otolaryngology | 401 Bicentennial Way, Santa Rosa, CA 95403-2149 | 2006-11-01 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.