PETER ALLEN NOVOTA (NPI# 1124132394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124132394 |
| Entity Type | Individual |
| Full Name | PETER ALLEN NOVOTA |
| Credential | M.D. |
| Practice Address |
3110 Kerner Blvd San Rafael CA 94901-5411 |
| Mailing Address |
2357 Sequoia Dr Aurora IL 60506-6222 |
| Practice Telephone | 4154481500 |
| Practice Fax Number | 4155268570 |
| Mailing Telephone | 6308596800 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2019-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | G156549 | CA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 036091570 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036091570 | 05 |
| Street Address |
3110 KERNER BLVD |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-5411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457986762 | Erick Estrada | Dental Hygienist | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2020-03-06 |
| 1003454489 | Emmeline Lui | Dental Hygienist | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2019-12-16 |
| 1356804827 | Casey William Holden | Nurse Practitioner | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2019-04-10 |
| 1952844946 | Audrey Maureen Combs | Nurse Practitioner | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2016-11-23 |
| 1457893190 | Dena Ito | Acupuncturist | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2016-11-11 |
| 1891161113 | Radka Varimezova Temnitzer | Dentist | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2015-08-20 |
| 1316353717 | Joann Gruener | Dietary Manager | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2014-07-07 |
| 1508108820 | Anita Sree Kris | Dentist | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2013-03-25 |
| 1134417850 | Neda Meshkin | Dentist | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2011-07-14 |
| 1922303437 | Marin Community Clinic | Clinic/Center | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2011-01-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760833834 | Sutter Bay Medical Foundation | Family Medicine | 750 Las Gallinas Ave Ste 210, San Rafael, CA 94903-3432 | 2016-06-29 |
| 1063798940 | Rimon Issac D.o. Inc | Family Medicine | 18 Ninestone Ct, San Rafael, CA 94903 | 2011-10-24 |
| 1316197320 | Georjana Grace Shames | Family Medicine | 25 Mitchell Blvd Ste 8, San Rafael, CA 94903-2013 | 2008-09-25 |
| 1821263492 | Barbara Inwald | Family Medicine | 360 Ellen Dr, San Rafael, CA 94903-1605 | 2008-04-24 |
| 1356564363 | Barbara Newlon | Family Medicine | 818 5th Ave, #202, San Rafael, CA 94901-3262 | 2007-04-10 |
| 1073630141 | Howard Allen Thornton | Family Medicine | 26 Mark Dr, San Rafael, CA 94903-2260 | 2007-03-23 |
| 1891884243 | Kenneth James Lossing | Family Medicine | 909 Irwin St, San Rafael, CA 94901 | 2006-10-12 |
| 1629081161 | Charles E Calza | Family Medicine | 4174 Redwood Hwy, San Rafael, CA 94903-2618 | 2006-08-14 |
| 1205883121 | Meenal Sunit Lohtia | Family Medicine | 4000 Civic Center Drive, Suite 200, San Rafael, CA 94903 | 2006-05-27 |
| 1154382158 | Michael A Frumkin | Family Medicine | 30 Newport Way, San Rafael, CA 94901-4411 | 2006-03-29 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
Please comment or provide details below to improve the information on PETER ALLEN NOVOTA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.