MARIN COMMUNITY CLINIC NPI 1790788107

NPI Information

NPI: 1790788107
Provider Name: MARIN COMMUNITY CLINIC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
400 PROFESSIONAL CENTER DR
STE 424
NOVATO, CA
ZIP 94947
Phone: (415) 448-1531
Get Directions

MARIN COMMUNITY CLINIC is a federally qualified health center (fqhc) clinic center in Novato, CA. MARIN COMMUNITY CLINIC NPI is 1790788107. The provider is registered as an organization entity type.

The provider's business location address is:

400 PROFESSIONAL CENTER DR
STE 424
NOVATO, CA
ZIP 94947-368
Phone: (415) 448-1531
Fax: (415) 892-8732

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 5/31/2005 and was last updated on 1/28/2016.

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
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	1100491	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	551918	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	FQHC - NOVATO
2	1100491	OTHER	CALIFORNIA	DHS LICENSE- NOVATO
3	FHC70941	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: 11/14/2023

NPI Synchronization or Removal

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