MARIN HEALTHCARE DISTRICT (NPI# 1366819278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366819278 |
| Entity Type | Organization |
| Organization Name | MARIN HEALTHCARE DISTRICT |
| Other Organization Name | SIRONA VASCULAR CENTER |
| Practice Address |
100 Drakes Landing Rd # B Suite 250 Greenbrae CA 94904-2404 |
| Mailing Address |
1100 S Eliseo Dr Suite 2a Greenbrae CA 94904-2017 |
| Practice Telephone | 4154645400 |
| Practice Fax Number | 4154645413 |
| Mailing Telephone | 4154645400 |
| Mailing Fax Number | 4154645413 |
| Enumeration Date | 2015-08-26 |
| Last Update Date | 2015-08-26 |
| Authorized Official Name | LEE DOMANICO (CEO) |
| Authorized Official Telephone | 4154642090 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Sirona Vascular Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659609964 | Marin Healthcare District | Clinic/Center | 100 B Drakes Landing Road, Ste. 250, Greenbrae, CA 94904-3121 | 2009-11-24 |
| 1023484425 | Marin Healthcare District | Surgery | 75 Rowland Way, Suite 101, Novato, CA 94945-5037 | 2015-08-19 |
| 1770913741 | Marin Healthcare District | Internal Medicine | 1100 S Eliseo Dr, Suite 2a, Greenbrae, CA 94904-2017 | 2013-11-12 |
| 1467881201 | Marin Healthcare District | Urology | 1000 S Eliseo Dr, Suite 201, Greenbrae, CA 94904-2133 | 2013-11-02 |
| 1891124632 | Marin Healthcare District | Surgery | 1100 S Eliseo Dr, Suite 2a, Greenbrae, CA 94904-2017 | 2013-11-02 |
| 1942573555 | Marin Healthcare District | Family Medicine | 111 Second St, Sausalito, CA 94965-2526 | 2012-02-13 |
| 1174896799 | Marin Healthcare District | Family Medicine | 11150 Highway 1, Point Reyes Station, CA 94956-9756 | 2012-02-13 |
| 1164795829 | Marin Healthcare District | Internal Medicine | 2 Bon Air Rd, Suite 100, Larkspur, CA 94939-1141 | 2012-02-10 |
| 1851664528 | Marin Healthcare District | Internal Medicine | 165 Rowland Way, Suite 201, Novato, CA 94945-5038 | 2012-02-10 |
| 1336412006 | Marin Healthcare District | Internal Medicine | 1341 S Eliseo Dr, Suite 200, Greenbrae, CA 94904-2000 | 2012-02-10 |
| Street Address |
100 DRAKES LANDING RD # B SUITE 250 |
| City | GREENBRAE |
| State | CA |
| Zip Code | 94904-2404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295382372 | Stacey Nicole Drew | Occupational Therapist | 4 Ash Ave, Unit 10, Kentfield, CA 94904 | 2019-08-22 |
| 1154781631 | Harvey Sparks | Specialist/Technologist, Other | 350 Bon Air, Ste 100, Greenbrae, CA 94904 | 2016-02-26 |
| 1396120481 | Tamena Potts | Counselor | 1109 Sir Francis Drake, Kentfield, CA 94904 | 2015-07-30 |
| 1598014763 | Rupali Ray Chaudhuri | Nurse Practitioner | 1341 S. Eliseo Dr, Suite 200, Greenbrae, CA 94904 | 2012-09-04 |
| 1326304809 | Lucy Yingxin Zhang | Ophthalmology | 900 S Eliseo Dr Ste 102, Greenbrae, CA 94904 | 2012-04-09 |
| 1396073185 | Bonnie Louise Hoag | Marriage & Family Therapist | 905 Sir Francis Drake Blvd., Ste. F., Kentfield, CA 94904 | 2009-12-07 |
| 1801043880 | Alexander Vogel Uihlein | Internal Medicine | 900 S Eliseo Dr Ste 201, Greenbrae, CA 94904 | 2008-08-21 |
| 1649426115 | Marilyn Thatcher | Psychologist | 1010 Sir Francis Drake Blve, Ste. 103, Kentfield, CA 94904 | 2008-08-14 |
| 1205007598 | Sir Francis Drake Dental | Dentist | 919 Sir Francis Drake Blvd, Kentfield, CA 94904 | 2008-03-14 |
| 1841401734 | Rishi K Wadhwa | Neurological Surgery | 1100 S Eliseo Dr Ste 1, Greenbrae, CA 94904 | 2007-05-24 |
| Find all providers in zip 94904 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891124632 | Marin Healthcare District | Surgery | 1100 S Eliseo Dr, Suite 2a, Greenbrae, CA 94904-2017 | 2013-11-02 |
| 1194715912 | Laura K. Pak | Surgery | 1100 S Eliseo Dr, Suite 2a, Greenbrae, CA 94904-2017 | 2005-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881213817 | Robert Morton Carroll X | Surgery | 2241 Century Hl, Los Angeles, CA 90067-3506 | 2020-04-09 |
| 1992341895 | Surgicalist of Ca PC | Surgery | 3300 E South St Ste 301a, Lakewood, CA 90805-4549 | 2019-11-26 |
| 1528600558 | Kevin M Casey Md Apmc | Surgery | 1919 State St # 204-206, Santa Barbara, CA 93101-2430 | 2019-10-10 |
| 1487117594 | John Nastasi | Surgery | 100 W Valencia Mesa Dr # 211, Fullerton, CA 92835-3768 | 2019-04-08 |
| 1225508385 | Jay Labourene | Surgery | 1550 G Tiburon Blvd, Tiburon, CA 94920-2531 | 2018-12-03 |
| 1467922120 | Paul Bressman Md Inc | Surgery | 1493 S Crest Dr, Los Angeles, CA 90035-3339 | 2018-11-26 |
| 1437638517 | Thousand Oaks Vein Clinic PC | Surgery | 225 N Moorpark Rd Ste C, Thousand Oaks, CA 91360-4320 | 2018-08-09 |
| 1881186377 | Lavs Access Center Inc. | Surgery | 620 W Beverly Blvd Ste B, Montebello, CA 90640-3624 | 2018-05-31 |
| 1841789328 | Sunil Rayan, M.d., Inc. | Surgery | 320 Santa Fe Dr Ste 212, Encinitas, CA 92024-5139 | 2018-05-09 |
| 1245739820 | Northridge Vascular Center A Professional Medical Corporation | Surgery | 19331 Business Center Dr Ste 102, Northridge, CA 91324-3533 | 2018-02-08 |
| Find all providers with the same taxonomy | ||||
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| 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.