Provider Demographics
NPI:1831104207
Name:JEANNETTE B. CURRIE, M.D. , INC.
Entity type:Organization
Organization Name:JEANNETTE B. CURRIE, M.D. , INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:BARBARELLA
Authorized Official - Last Name:CURRIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-545-7795
Mailing Address - Street 1:1275 4TH ST
Mailing Address - Street 2:SUITE 151
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4057
Mailing Address - Country:US
Mailing Address - Phone:707-545-7795
Mailing Address - Fax:
Practice Address - Street 1:1275 4TH ST
Practice Address - Street 2:SUITE 151
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4057
Practice Address - Country:US
Practice Address - Phone:707-545-7795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02505ZMedicare PIN