SOLANO REGIONAL MEDICAL GROUP INC (NPI# 1063676195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063676195 |
| Entity Type | Organization |
| Organization Name | SOLANO REGIONAL MEDICAL GROUP INC |
| Practice Address |
770 Mason St Vacaville CA 95688-4646 |
| Mailing Address |
Po Box 254978 Sacramento CA 95865-4978 |
| Practice Telephone | 8004700071 |
| Mailing Telephone | 8004700071 |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2008-07-17 |
| Authorized Official Name | DR. RONALD B RUSHFORD (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7074342049 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOLANO REGIONAL MEDICAL GROUP INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0206X |
Clinic/Center Specialization: Radiology, Mammography |
Ambulatory Health Care Facilities | ||
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0059866 | 05 |
| Street Address |
770 MASON ST |
| City | VACAVILLE |
| State | CA |
| Zip Code | 95688-4646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295703189 | Ricardo Edward Denapoli | Family Medicine | 770 Mason St, Vacaville, CA 95688-4646 | 2006-03-08 |
| 1144700436 | Sutter Valley Medical Foundation | Durable Medical Equipment & Medical Supplies | 770 Mason St, Vacaville, CA 95688-4646 | 2018-08-16 |
| 1912434192 | Shilpa Chopra | Pediatrics | 770 Mason St, Vacaville, CA 95688-4646 | 2017-05-18 |
| 1477086320 | Michael Benjamin Olalia | Internal Medicine | 770 Mason St, Vacaville, CA 95688-4646 | 2017-04-07 |
| 1134675176 | Mariela Woods | Nurse Practitioner | 770 Mason St, Vacaville, CA 95688-4646 | 2016-08-30 |
| 1871964353 | Stephanie Sandeep Purewal | Physician Assistant | 770 Mason St, Vacaville, CA 95688 | 2015-10-09 |
| 1003292608 | Jeffrey Youngberg | Dentist | 770 Mason St, Suite 110, Vacaville, CA 95688-4646 | 2015-08-05 |
| 1568897718 | Holly L Pulket | Physical Therapist | 770 Mason St, Vacaville, CA 95688-4646 | 2013-09-06 |
| 1790025922 | Catherine Anthony-tkach | Nurse Practitioner | 770 Mason St, Vacaville, CA 95688-4646 | 2013-02-25 |
| 1932475548 | Damoon Rejaei | Physical Medicine & Rehabilitation | 770 Mason St, Vacaville, CA 95688 | 2012-03-28 |
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|---|---|---|---|---|
| 1851917165 | Katelyn Renee Watson | Military Health Care Provider | 101 Bodin Drive, Bldg 777, Fairfield, CA 95688 | 2020-06-23 |
| 1043842917 | Dr. Page Hudson Dental Corporation | Dentist | 1671 East Monte Vista Ave, Suite 200, Vacaville, CA 95688 | 2020-02-10 |
| 1356981534 | Demi Renae Holder | Behavior Technician | 6801 Leisure Town Rd Apt. 153, Vacaville, CA 95688 | 2020-01-15 |
| 1073089074 | Sukhdeep Kaur | Nurse Practitioner | 679 E Monte Vista Ave #140, Vacaville, CA 95688 | 2018-10-17 |
| 1114419553 | Sharlie Mccurry | Behavior Technician | 3333 Vaca Valley Pkwy, Suite 900, Vacaville, CA 95688 | 2018-06-01 |
| 1720577307 | Ana Lynch | Behavioral Analyst | 250 Grape St, Vacaville, CA 95688 | 2018-05-09 |
| 1508382011 | Esther's Empowerment Leadership Institute, LLC | Health Educator | 227 Fairoaks Drive, Vacaville, CA 95688 | 2017-08-16 |
| 1023534807 | Jean Allyson Garcia | Counselor | 1286 Callen Street, Vacaville, CA 95688 | 2017-08-14 |
| 1437692043 | Ahmed Abdi Ali | Pharmacist | 1 Quality Drive, Mob-b 1st Flr, 24 Hrs Pharmacy, Vacaville, CA 95688 | 2016-11-30 |
| 1275961807 | Laura Hitt | Dietitian, Registered | 107 Blackwood Ct, Vacaville, CA 95688 | 2013-10-16 |
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| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356434203 | Sutter Regional Medical Foundation | Clinic/Center | 770 Mason St, Vacaville, CA 95688-4646 | 2006-10-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.