Healthcare Provider Details

I. General information

NPI: 1780736736
Provider Name (Legal Business Name): NORTHBAY HEALTHCARE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 PENNSYLVANIA AVE STE 230
FAIRFIELD CA
94533-3550
US

IV. Provider business mailing address

4500 BUSINESS CENTER DR
FAIRFIELD CA
94534-6888
US

V. Phone/Fax

Practice location:
  • Phone: 707-646-4370
  • Fax:
Mailing address:
  • Phone: 707-646-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2278P1005X
TaxonomyPulmonary Rehabilitation Certified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH DANGINA
Title or Position: CFO
Credential:
Phone: 707-646-3111