Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

4th Street Laser & Surgery Center Inc

Organization Ambulatory Surgical Clinic/Center · NPI 1902964174

4th Street Laser & Surgery Center Inc is an Ambulatory Surgical Clinic/Center in Santa Rosa, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1720 4th St
Santa Rosa, CA 95404-3602
Phone: (707) 546-8100
Fax: (707) 544-6438
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence 110000344 (CA)

Record details

NPI number1902964174
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Elayne Clark — Administrator · (707) 546-8100
NPI enumeratedDecember 4, 2006
Last updated in NPPESJanuary 17, 2013
Mailing address1720 4th St, Santa Rosa, CA 95404-3602

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