ROSS VALLEY MEDICAL CORPORATION NPI 1902852510

NPI Information

NPI: 1902852510
Provider Name: ROSS VALLEY MEDICAL CORPORATION
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

CLIA Number: 05D1104145

Address:
1000 S. ELISEO DR. STE 204
GREENBRAE, CA
ZIP 94903
Phone: (415) 461-2262
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ROSS VALLEY MEDICAL CORPORATION is an adult medicine family medicine in Greenbrae, CA. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. ROSS VALLEY MEDICAL CORPORATION NPI is 1902852510. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1000 S. ELISEO DR. STE 204
GREENBRAE, CA
ZIP 94903
Phone: (415) 461-2262
Fax: (415) 461-9376

The provider's authorized official is Flash Gordon .
The authorized official title is Owner , Ceo and has the following contact phone number (415) 461-2262.

The CLIA number assigned to this NPI record is 05D1104145 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 12/2/2014.

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	207R00000X	Internal Medicine		A61715	CALIFORNIA	No
2	207QA0505X	Family Medicine	Adult Medicine	G37304	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
1	ZZZ31139Z	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
2	00G373040	MEDICARE OSCAR/CERTIFICATION	CALIFORNIA
3	A47033	MEDICARE UPIN

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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