PRIMA MEDICAL GROUP-TERRA LINDA NPI 1730463258

NPI Information

NPI: 1730463258
Provider Name: PRIMA MEDICAL GROUP-TERRA LINDA
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
4000 CIVIC CENTER DRIVE
SUITE 200B
SAN RAFAEL, CA
ZIP 94903
Phone: (415) 492-3333
Get Directions

PRIMA MEDICAL GROUP-TERRA LINDA is a general practice in San Rafael, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee PRIMA MEDICAL GROUP-TERRA LINDA NPI is 1730463258. The provider is registered as an organization entity type.

The provider's business location address is:

4000 CIVIC CENTER DRIVE
SUITE 200B
SAN RAFAEL, CA
ZIP 94903
Phone: (415) 492-3333
Fax: (415) 492-3425

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 10/3/2011 and was last updated on 8/14/2012.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	G55637	CALIFORNIA	No
2	208D00000X	General Practice		G73451	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	222035382	MEDICARE OSCAR/CERTIFICATION	CALIFORNIA

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: 4/28/2024

NPI Synchronization or Removal

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