PRIMA MEDICAL FOUNDATION SEBASTOPOL NPI 1154590958

NPI Information

NPI: 1154590958
Provider Name: PRIMA MEDICAL FOUNDATION SEBASTOPOL

Doing Business As: PRIMA MEDICAL GROUP

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
652 PETALUMA AVE
SUITE H
SEBASTOPOL, CA
ZIP 95472
Phone: (707) 823-7616
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PRIMA MEDICAL FOUNDATION SEBASTOPOL is a multi-specialty clinic center in Sebastopol, CA. PRIMA MEDICAL FOUNDATION SEBASTOPOL NPI is 1154590958. The provider is registered as an organization entity type.
The provider Is Doing Business As Prima Medical Group.

The provider's business location address is:

652 PETALUMA AVE
SUITE H
SEBASTOPOL, CA
ZIP 95472-256
Phone: (707) 823-7616
Fax: (707) 823-2803

The provider's authorized official is Dennis Mondragon .
The authorized official title is Coo and has the following contact phone number (415) 884-1840.

The enumeration date for this NPI number is 2/26/2008 and was last updated on 4/24/2013.

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	261QP2300X	Clinic/Center	Primary Care			No
2	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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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