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DAVID M TULLY SMITH M D A MEDICAL CORPORATION NPI 1780728246


NPI Information

NPI: 1780728246
Provider Name: DAVID M TULLY SMITH M D A MEDICAL CORPORATION

Doing Business As: MILL VALLEY MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
711 D ST
SUITE 111
SAN RAFAEL, CA
ZIP 94901
Phone: (415) 453-3030
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DAVID M TULLY SMITH M D A MEDICAL CORPORATION is a family medicine in San Rafael, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DAVID M TULLY SMITH M D A MEDICAL CORPORATION NPI is 1780728246. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mill Valley Medical Group.

The provider's business location address is:

711 D ST
SUITE 111
SAN RAFAEL, CA
ZIP 94901-707
Phone: (415) 453-3030

The provider's authorized official is Dana Tully-smith .
The authorized official title is Vice President and has the following contact phone number (707) 544-2632.

The enumeration date for this NPI number is 2/17/2007 and was last updated on 11/7/2008.


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
1207Q00000XFamily MedicineG30229CALIFORNIAYes

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
1ZZZ30674ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAGROUP NUMBER

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

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