DOL Form 5500 · JSON-LD · Markdown

PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA BENEFITS WELFARE PLAN

Sponsored by PROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA · EIN 881779768 · CA

Participants
301
Active
308
Retired/sep receiving
2

Welfare benefits

4A4B4D4E4F4H4Q 4A4B4D4E4F4H4Q

Sponsor + Administrator

SponsorPROVIDENCE MEDICAL GROUP, NORTHERN CALIFORNIA
Sponsor EIN881779768
Address185 SOTOYOME STREET, SANTA ROSA, CA, 95405
Phone7073873927
Business code (NAICS)621111
Plan number501
Plan effective2022-07-01
Filed for year2024
FundingInsurance contracts, General assets

External sources

Source: DOL EBSA Form 5500 disclosure. Public domain.