Healthcare Provider Details
I. General information
NPI: 1679652358
Provider Name (Legal Business Name): REDWOOD REGIONAL MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
181 LYNCH CREEK WAY STE 102
PETALUMA CA
94954-2388
US
IV. Provider business mailing address
181 LYNCH CREEK WAY STE 102
PETALUMA CA
94954-2388
US
V. Phone/Fax
- Phone: 707-766-7074
- Fax: 707-766-7075
- Phone: 707-766-7074
- Fax: 707-766-7075
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085B0100X |
| Taxonomy | Body Imaging Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0700X |
| Taxonomy | Neuroradiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085N0904X |
| Taxonomy | Nuclear Radiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
H.
SCHMIDT
Title or Position: M.D./RADIOLOGIST
Credential: M.D.
Phone: 707-546-4062