Provider Demographics
NPI:1912337478
Name:ST. HELENA SPORTS MEDICINE & ORTHOPAEDICS, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:ST. HELENA SPORTS MEDICINE & ORTHOPAEDICS, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANZINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-258-2547
Mailing Address - Street 1:3435 VALLE VERDE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2458
Mailing Address - Country:US
Mailing Address - Phone:707-258-2547
Mailing Address - Fax:
Practice Address - Street 1:3435 VALLE VERDE DR
Practice Address - Street 2:SUITE B
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-2458
Practice Address - Country:US
Practice Address - Phone:707-258-2547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76023261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACN977AOtherMEDICARE PTAN
CA=========OtherTAX ID