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General NPI Number Information
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NPI Number | 1154194298
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Entity Type | Organization
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Legal Business Name | REDWOOD SURGICAL INSTITUTE
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Dates
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Enumeration Date | 10/31/2023
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 127 HOSPITAL DR STE 102
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City | VALLEJO
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State | CA
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Zip | 94589-2500
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Country | US
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Telephone | 916-768-2980
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Fax |
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Provider Business Mailing Address
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Address Line | 127 HOSPITAL DR STE 102
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City | VALLEJO
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State | CA
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Zip | 94589-2500
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Country | US
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Telephone | 916-768-2980
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PAUL SCHRUPP
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Credential |
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Telephone | 916-768-2890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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