MARIN COMMUNITY CLINIC (NPI# 1780292912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780292912 |
Entity Type | Organization |
Organization Name | MARIN COMMUNITY CLINIC |
Practice Address |
1260 S Eliseo Dr Ste 201 Greenbrae CA 94904-2009 |
Mailing Address |
Po Box 5008 Novato CA 94948-5008 |
Practice Telephone | 4154481500 |
Practice Fax Number | 4157983104 |
Mailing Telephone | 4157983135 |
Mailing Fax Number | 4157983104 |
Enumeration Date | 2020-07-14 |
Last Update Date | 2020-07-14 |
Authorized Official Name | ANDREA M SKELLY (REVENUE CREDENTIALING MANAGER) |
Authorized Official Telephone | 4157983135 |
Authorized Official Credential | CPC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
1790788107 | Marin Community Clinic | Clinic/Center | 400 Professional Center Dr, Ste 424, Novato, CA 94947-4368 | 2005-05-31 |
1124021738 | Marin Community Clinic | Clinic/Center | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2005-05-27 |
1881057115 | Marin Community Clinic | Clinic/Center | 6090 Redwood Blvd, Novato, CA 94945-4569 | 2016-04-04 |
1922303437 | Marin Community Clinic | Clinic/Center | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2011-01-13 |
1912220781 | Marin Community Clinic | Clinic/Center | 6090 Redwood Blvd, Suite D, Novato, CA 94945-4569 | 2010-03-09 |
1154503399 | Marin Community Clinic | Clinic/Center | 3110 Kerner Blvd, San Rafael, CA 94901-5411 | 2007-11-29 |
1932327343 | Marin Community Clinic | Clinic/Center | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2007-04-23 |
1669690079 | Marin Community Clinic | Clinic/Center | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2007-04-23 |
1912091018 | Marin Community Clinic | Clinic/Center | 5 Bon Air Rd, Larkspur, CA 94939-1143 | 2006-10-03 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MARIN COMMUNITY CLINICS | 9 Commercial Blvd Ste 100, Novato, CA 94949-6137 |
Street Address |
1260 S ELISEO DR STE 201 |
City | GREENBRAE |
State | CA |
Zip Code | 94904-2009 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316547193 | Pharmedquest Pharmacy Services | Pharmacy | 1260 S Eliseo Dr Ste 201, Greenbrae, CA 94904-2009 | 2020-10-29 |
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 | 261QC1500X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Community Health |
Definition to come... |
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1740812866 | Tauna Mcginnis | Clinic/Center | 1570 Soquel Dr Ste 4, Santa Cruz, CA 95065-1715 | 2020-02-06 |
1275173403 | United Advocates for Children and Families | Clinic/Center | 2143 Hurley Way Ste 102, Sacramento, CA 95825-3297 | 2020-01-15 |
1083251532 | Prime Wellness Community Health Center | Clinic/Center | 1824 1/2 W 38th Pl, Los Angeles, CA 90062-1012 | 2019-12-03 |
1841836301 | Beverlycare | Clinic/Center | 101 E Beverly Blvd Ste 301, Montebello, CA 90640-4316 | 2019-11-20 |
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.