Healthcare Provider Details

I. General information

NPI: 1760534713
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: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 NUT TREE RD # 390
VACAVILLE CA
95687-4100
US

IV. Provider business mailing address

4500 BUSINESS CENTER DR
FAIRFIELD CA
94534-6888
US

V. Phone/Fax

Practice location:
  • Phone: 707-624-8000
  • Fax:
Mailing address:
  • Phone: 707-646-3286
  • Fax: 707-646-4886

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 Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number110000093
License Number StateCA

VIII. Authorized Official

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