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PRIMA MEDICAL FOUNDATION NPI 1366606766


NPI Information

NPI: 1366606766
Provider Name: PRIMA MEDICAL FOUNDATION
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
655 REDWOOD HIGHWAY
SUITE 216
MILL VALLEY, CA
ZIP 94941
Phone: (415) 383-3500
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PRIMA MEDICAL FOUNDATION 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. PRIMA MEDICAL FOUNDATION NPI is 1366606766. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

655 REDWOOD HIGHWAY
SUITE 216
MILL VALLEY, CA
ZIP 94941
Phone: (415) 383-3500
Fax: (415) 383-3554

The provider's authorized official is Joel A. Criste .
The authorized official title is Ceo and has the following contact phone number (415) 884-1840.

The enumeration date for this NPI number is 7/15/2008 and was last updated on 8/31/2012.


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
1208000000XPediatricsG55637CALIFORNIANo
2208600000XSurgeryA65187CALIFORNIANo
3208D00000XGeneral PracticeNo
4208000000XPediatricsA77821CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1222035382MEDICARE OSCAR/CERTIFICATIONCALIFORNIA

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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