OrganizationActive
Entegrative Otolaryngology PC
NPI 1417294174 · Otolaryngology/Facial Plastic Surgery Physician · Santa Rosa, CA
Provider details
- NPI number
- 1417294174
- Entity type
- Organization
- Primary specialty
- Otolaryngology/Facial Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Larry Gambrell, Director/Ceo(267) 456-4848
- License
- C3527438 (CA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1144 Sonoma Ave Ste 101
Santa Rosa, CA 95405-4812
Phone: (707) 775-0775
Approximate (ZIP-level) locationGet directions
Mailing address
1144 Sonoma Ave Ste 101
Santa Rosa, CA 95405-4812
Registry dates
- Enumerated
- 2013-01-14
- Last updated
- 2013-01-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.