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LIFELONG MEDICAL CARE NPI 1518963693


NPI Information

NPI: 1518963693
Provider Name: LIFELONG MEDICAL CARE

Doing Business As: BERKELEY PRIMARY CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D2290661

Address:
2001 DWIGHT WAY
RM 1363
BERKELEY, CA
ZIP 94704
Phone: (510) 204-4666
Get Directions

LIFELONG MEDICAL CARE is a family medicine in Berkeley, 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. LIFELONG MEDICAL CARE NPI is 1518963693. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Berkeley Primary Care.

The provider's business location address is:

2001 DWIGHT WAY
RM 1363
BERKELEY, CA
ZIP 94704-608
Phone: (510) 204-4666

The provider's authorized official is Marty Lynch .
The authorized official title is Ceo and has the following contact phone number (510) 981-4100.

The CLIA number assigned to this NPI record is 05D2290661 - school/student health service with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/23/2005 and was last updated on 10/23/2009.


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 Medicine140000372CALIFORNIAYes

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
1HAP70474GOTHERCALIFORNIAFAMILY PACT
2FHC70474GMEDICAIDCALIFORNIA
3551811MEDICARE 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: 4/28/2024

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