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MARIN COMMUNITY CLINIC NPI 1154503399


NPI Information

NPI: 1154503399
Provider Name: MARIN COMMUNITY CLINIC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
3110 KERNER BLVD
SAN RAFAEL, CA
ZIP 94901
Phone: (415) 526-8500
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MARIN COMMUNITY CLINIC is a federally qualified health center (fqhc) clinic center in San Rafael, CA. MARIN COMMUNITY CLINIC NPI is 1154503399. The provider is registered as an organization entity type.

The provider's business location address is:

3110 KERNER BLVD
SAN RAFAEL, CA
ZIP 94901-411
Phone: (415) 526-8500
Fax: (415) 526-8553

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 enumeration date for this NPI number is 11/29/2007 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)CALIFORNIAYes

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
1051131MEDICARE PINCALIFORNIA
2051131MEDICARE 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: 5/5/2024
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