LIFELONG MEDICAL CARE NPI 1720084163

NPI Information

NPI: 1720084163
Provider Name: LIFELONG MEDICAL CARE

Doing Business As: WEST BERKELEY FAMILY PRACTICE

Classification: Family Medicine - 207QA0000X
Entity Type: Organization

Specialization: Adolescent Medicine

Address:
2031 6TH ST
BERKELEY, CA
ZIP 94710
Phone: (510) 981-4200
Get Directions

LIFELONG MEDICAL CARE is an adolescent medicine family medicine in Berkeley, CA. The provider is a family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. LIFELONG MEDICAL CARE NPI is 1720084163. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As West Berkeley Family Practice.

The provider's business location address is:

2031 6TH ST
BERKELEY, CA
ZIP 94710-006
Phone: (510) 981-4200

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 4/4/2022.

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	171M00000X	Case Manager/Care Coordinator				No
2	207QA0505X	Family Medicine	Adult Medicine	020000503	CALIFORNIA	No
3	207V00000X	Obstetrics & Gynecology		020000503	CALIFORNIA	No
4	208000000X	Pediatrics		020000503	CALIFORNIA	No
5	207QA0000X	Family Medicine	Adolescent Medicine	020000503	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	HAP70635F	OTHER	CALIFORNIA	FAMILY PACT
2	FHC70635F	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

NPI Synchronization or Removal

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