PETALUMA SURGICENTER
Ambulatory Health at Professional Dr, Petaluma, CA

License number
California 110000263
Category
Ambulatory Health
Type
Podiatric
Owner
Name: RONALD LAVIGNA DPM
Title: OWNER
Phone: (707) 763-9325
Address
Address
1400 Professional Dr SUITE 102, Petaluma, CA 94954
National Provider ID: 1326259276
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Petaluma Surgicenter, LLC

Petaluma, CA

Industry:
General Hospital, Outpatient Surgery Center
Registration:
Jul 28, 2003
Addresses:
1400 Prof Dr, Petaluma, CA 94954
1400 Professional Dr, Petaluma, CA 94954
State ID:
200320910123
Business type:
Domestic
Members:
Margaret Weiss (Office Manager, Principal),Ronald M. Lavigna (Member),Michael L. Tran (Member)
Agent:
Michael M K Sebree

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