Provider Demographics
NPI:1437103884
Name:MUNRO, BOOTH & CUTRUZZOLA
Entity Type:Organization
Organization Name:MUNRO, BOOTH & CUTRUZZOLA
Other - Org Name:SONOMA IMAGING MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:CUTRUZZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-261-7880
Mailing Address - Street 1:PO BOX 6523
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-6523
Mailing Address - Country:US
Mailing Address - Phone:714-571-5000
Mailing Address - Fax:714-571-5055
Practice Address - Street 1:1375 UNIVERSITY ST
Practice Address - Street 2:
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3382
Practice Address - Country:US
Practice Address - Phone:707-431-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0083020Medicaid
CAZZZ15381ZMedicare PIN
CAZZZ15381ZMedicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
CAGR0083020Medicaid