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MAGNOLIA PEDIATRICS OF MARIN INC. NPI 1194287680


NPI Information

NPI: 1194287680
Provider Name: MAGNOLIA PEDIATRICS OF MARIN, INC.
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D1075837

Address:
655 REDWOOD HWY FRONTAGE RD STE 216
MILL VALLEY, CA
ZIP 94941
Phone: (415) 380-8711
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MAGNOLIA PEDIATRICS OF MARIN, INC. is a pediatrics in Mill Valley, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MAGNOLIA PEDIATRICS OF MARIN, INC. NPI is 1194287680. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

655 REDWOOD HWY FRONTAGE RD STE 216
MILL VALLEY, CA
ZIP 94941-055
Phone: (415) 380-8711

The provider's authorized official is Suzanne Christie .
The authorized official title is President and has the following contact phone number (415) 380-8700.

The CLIA number assigned to this NPI record is 05D1075837 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/3/2019 and was last updated on 4/3/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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