| CASE NUMBER | I-200-24012-639120 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/12/2024 |
| DECISION DATE | 1/22/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Hospitalist Physician |
| SOC CODE | 29-1229.02 |
| SOC TITLE | Hospitalists |
| FULL TIME POSITION | Y |
| BEGIN DATE | 7/1/2024 |
| END DATE | 6/30/2027 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 1 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | NorthBay Hospital Based Specialists, Inc. |
| TRADE NAME DBA | |
| EMPLOYER ADDRESS1 | 1200 B. Gale Wilson Blvd |
| EMPLOYER ADDRESS2 | Suite 1559 |
| EMPLOYER CITY | Fairfield |
| EMPLOYER STATE | CA |
| EMPLOYER POSTAL CODE | 94533 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 17078166932 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 621111 |
| EMPLOYER POC LAST NAME | Pravin |
| EMPLOYER POC FIRST NAME | Paresh |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | President |
| EMPLOYER POC ADDRESS1 | 1200 B. Gale Wilson Blvd. |
| EMPLOYER POC ADDRESS2 | Suite 1559 |
| EMPLOYER POC CITY | Fairfield |
| EMPLOYER POC STATE | CA |
| EMPLOYER POC POSTAL CODE | 94533 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 17078166932 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | PPravin@NorthBay.org |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Peterson / Vang |
| AGENT ATTORNEY FIRST NAME | Sarah / Yer |
| AGENT ATTORNEY MIDDLE NAME | K. / C. |
| AGENT ATTORNEY ADDRESS1 | 3033 Excelsior Boulevard |
| AGENT ATTORNEY ADDRESS2 | STE 300 |
| AGENT ATTORNEY CITY | Minneapolis |
| AGENT ATTORNEY STATE | MN |
| AGENT ATTORNEY POSTAL CODE | 55416 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 16123518100 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | mn-filed@fragomen.com |
| LAWFIRM NAME BUSINESS NAME | Fragomen, Del Rey, Bernsen & Loewy, LLP |
| STATE OF HIGHEST COURT | MN |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | Yes |
| SECONDARY ENTITY BUSINESS NAME | NorthBay Medical Center |
| WORKSITE ADDRESS1 | 1200 B Gale Wilson Blvd |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Fairfield |
| WORKSITE COUNTY | SOLANO |
| WORKSITE STATE | CA |
| WORKSITE POSTAL CODE | 94533 |
| WAGE RATE OF PAY FROM | 328500 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $147,909.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2023 - 6/30/2024 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2024-01-07 |
