MEDICARE: DR. STEPHANIE ANNE SOBCZYNSKI-PATTON D.O., M.P.H

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	98 355822-1204	UT
2	207Q00000X	Family Medicine Physician	20A6967	CA
3	2083X0100X	Occupational Medicine Physician	20A6967	CA
4	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	20A6967	CA

General Provider Information

NPI Number	:	1831385186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHANIE ANNE SOBCZYNSKI-PATTON D.O., M.P.H

Provider Business Mailing Address
First Line	:	275 HOSPITAL DR
Second Line	:
City	:	UKIAH
State	:	CA
Zip	:	95482-4531
Country	:	US
Telephone Number	:	707-380-1075
Fax Number	:	707-462-7947

Provider Business Practice Location Address
First Line	:	232 HOSPITAL DR STE B
Second Line	:
City	:	UKIAH
State	:	CA
Zip	:	95482-4562
Country	:	US
Telephone Number	:	707-462-7900
Fax Number	:	707-462-7947

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2007
Last Update Date	:	05/09/2018

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