MARIN COMMUNITY CLINIC NPI 1932327343

NPI Information

NPI: 1932327343
Provider Name: MARIN COMMUNITY CLINIC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D1002008

Address:
250 BON AIR RD
GREENBRAE, CA
ZIP 94904
Phone: (415) 448-1500
Get Directions

MARIN COMMUNITY CLINIC is a federally qualified health center (fqhc) clinic center in Greenbrae, CA. MARIN COMMUNITY CLINIC NPI is 1932327343. The provider is registered as an organization entity type.

The provider's business location address is:

250 BON AIR RD
GREENBRAE, CA
ZIP 94904-702
Phone: (415) 448-1500

The provider's authorized official is Kathy Cruz .
The authorized official title is Medical Staff Coordinator and has the following contact phone number (415) 448-1579.

The CLIA number assigned to this NPI record is 05D1002008 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/23/2007 and was last updated on 6/10/2009.

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	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			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	BCP11975F	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: 5/5/2024

NPI Synchronization or Removal

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