LIFELONG MEDICAL CARE NPI 1689670002

NPI Information

NPI: 1689670002
Provider Name: LIFELONG MEDICAL CARE

Doing Business As: OVER SIXTY HEALTH CENTER

Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
3260 SACRAMENTO ST
BERKELEY, CA
ZIP 94702
Phone: (510) 428-4500
Get Directions

LIFELONG MEDICAL CARE is a geriatric medicine family medicine in Berkeley, CA. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. LIFELONG MEDICAL CARE NPI is 1689670002. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Over Sixty Health Center.

The provider's business location address is:

3260 SACRAMENTO ST
BERKELEY, CA
ZIP 94702-739
Phone: (510) 428-4500

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 enumeration date for this NPI number is 6/21/2005 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine	140000191	CALIFORNIA	No
2	207QG0300X	Family Medicine	Geriatric Medicine	140000191	CALIFORNIA	Yes

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
1	551871	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	PART B UGS
2	ZZZ89670Z	MEDICARE PIN	CALIFORNIA
3	FHC70859F	MEDICAID	CALIFORNIA

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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