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General NPI Number Information
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NPI Number | 1104151844
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Entity Type | Organization
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Legal Business Name | NORTHBAY HEALTHCARE GROUP
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Dates
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Enumeration Date | 10/14/2009
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Last Update Date | 10/14/2009
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Provider Practice Location Address
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Address Line | 1000 NUT TREE RD
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City | VACAVILLE
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State | CA
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Zip | 95687-4100
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Country | US
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Telephone | 707-646-4193
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Fax | 707-399-2651
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Provider Business Mailing Address
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Address Line | 1000 NUT TREE RD
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City | VACAVILLE
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State | CA
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Zip | 95687-4100
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Country | US
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Telephone | 707-646-4193
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Fax | 707-399-2651
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Authorized Official
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Title or Position | VICE PRESIDENT ADMINSTRATIVE SERV
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Name | MS. MARGARET E WALBOLT
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Credential |
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Telephone | 707-646-4196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 110000093
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License Number State | CA
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