MARIN COMMUNITY CLINIC NPI 1003900101

NPI Information

  • NPI: 1003900101
  • Provider Name: MARIN COMMUNITY CLINIC
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • CLIA Number: 05D2262622
  • Address: 6100 REDWOOD BLVD
    NOVATO, CA
    ZIP 94945
  • Phone: (415) 448-1500

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NPI Details

MARIN COMMUNITY CLINIC is a federally qualified health center (fqhc) clinic center in Novato, CA. MARIN COMMUNITY CLINIC NPI is 1003900101. The provider is registered as an organization entity type.

The provider's business location address is:

6100 REDWOOD BLVD
NOVATO, CA
ZIP 94945-505
Phone: (415) 448-1500
Fax: (415) 798-3198

The provider's authorized official is Deborah Udall .
The authorized official title is Director Of Patient Accounts and has the following contact phone number (415) 798-3106.

The CLIA number assigned to this NPI record is 05D2262622 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/3/2006 and was last updated on 1/6/2016.

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
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)110000491CALIFORNIAYes

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
1FHC70941MEDICAIDCALIFORNIA
2551918MEDICARE OSCAR/CERTIFICATIONCALIFORNIA
3551918MEDICARE PINCALIFORNIA

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: 3/30/2025

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