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General NPI Number Information
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NPI Number | 1295298115
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Entity Type | Organization
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Legal Business Name | SITKA MEDICAL ASSOCIATES PC
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Dates
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Enumeration Date | 04/08/2019
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Last Update Date | 01/31/2021
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Provider Practice Location Address
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Address Line | 75 BUENA VISTA
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City | STINSON BEACH
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State | CA
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Zip | 94970-5730
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Country | US
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Telephone | 813-530-8760
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Fax |
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Provider Business Mailing Address
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Address Line | 75 BUENA VISTA
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City | STINSON BEACH
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State | CA
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Zip | 94970-5730
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Country | US
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Telephone | 813-530-8760
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD ALAN GREENO
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Credential |
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Telephone | 323-646-3188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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