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

Santa Rosa Sports Medicine, Incorporated

Organization Sports Medicine (Family Medicine) Physician · NPI 1952555740

Santa Rosa Sports Medicine, Incorporated is a Sports Medicine (Family Medicine) Physician in Santa Rosa, California. Licensed in California. Registered with an NPI since 2008.

Licensed in
CA
In the registry since
2008

Practice location Address checks out

1255 N Dutton Ave
Santa Rosa, CA 95401-4663
Phone: (707) 546-9400
Fax: (707) 546-9464
Show map & directions

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

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence G073843 (CA)

Record details

NPI number1952555740
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ty Affleck — President · (707) 546-9400
Other names Santa Rosa Sports And Family Medicine
NPI enumeratedNovember 6, 2008
Last updated in NPPESOctober 13, 2014
Mailing address1255 N Dutton Ave, Santa Rosa, CA 95401-4663

Other providers in Santa Rosa