Healthcare Provider Details

I. General information

NPI: 1306902804
Provider Name (Legal Business Name): SOLANO REGIONAL MEDICAL GROU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 03/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 MASON ST
VACAVILLE CA
95688-4646
US

IV. Provider business mailing address

PO BOX 255668
SACRAMENTO CA
95865-5668
US

V. Phone/Fax

Practice location:
  • Phone: 707-454-5800
  • Fax: 707-454-5991
Mailing address:
  • Phone: 800-470-0071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: RONALD B RUSHFORD
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 707-434-2049