MEDICARE: NORTHBAY HEALTHCARE GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RR0500X	Rheumatology Physician
2	2084N0400X	Neurology Physician
3	207RX0202X	Medical Oncology Physician
4	207RG0100X	Gastroenterology Physician
5	2278P1005X	Pulmonary Rehabilitation Certified Respiratory Therapist
6	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110000093	OTHER	CA	DHS LICENSE
2	GR0093200	OTHER	CA	MEDI-CAL PHYSICIAN GROUP

General Provider Information

NPI Number	:	1780736736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHBAY HEALTHCARE GROUP

Provider Business Mailing Address
First Line	:	4500 BUSINESS CENTER DR
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-6888
Country	:	US
Telephone Number	:	707-646-3111
Fax Number	:

Provider Business Practice Location Address
First Line	:	1860 PENNSYLVANIA AVE STE 230
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-3550
Country	:	US
Telephone Number	:	707-646-4370
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JOSEPH DANGINA
Credential	:
Telephone Number	:	707-646-3111

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	01/22/2026

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Directions to “NORTHBAY HEALTHCARE GROUP ” Practice Location

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