MARIN MEDICAL LABORATORIES (NPI# 1053417386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053417386 |
| Entity Type | Organization |
| Organization Name | MARIN MEDICAL LABORATORIES |
| Other Organization Name | MARIN GENERAL HOSPITAL PATH DEPT. |
| Practice Address |
250 Bon Air Road Greenbrae CA 94904 |
| Mailing Address |
1615 Hill Rd Ste B Novato CA 94947-4338 |
| Practice Telephone | 4159257174 |
| Practice Fax Number | 4154617228 |
| Mailing Telephone | 4158987649 |
| Mailing Fax Number | 4158980870 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-11-08 |
| Authorized Official Name | DR. PAUL WILLIAM WASSERSTEIN (MANAGING PARTNER) |
| Authorized Official Telephone | 4159257174 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
CLF787 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0014390 | 05 |
| Other Name | Type Code |
|---|---|
| MARIN GENERAL HOSPITAL PATH DEPT. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144326471 | Marin Medical Laboratories | Pathology | 1615 Hill Road, Suite B, Novato, CA 94947 | 2006-09-15 |
| 1962504977 | Marin Medical Laboratories | Radiology | 1300 South Eliseo Drive, Suite 102, Greenbrae, CA 94904 | 2006-09-01 |
| 1326444647 | Marin Medical Laboratories | Pathology | 1165 Montgomery Dr, Santa Rosa, CA 95405-4801 | 2014-11-13 |
| 1346532314 | Marin Medical Laboratories | Pathology | 347 Andrieux St, Sonoma, CA 95476-6811 | 2011-05-10 |
| 1720393838 | Marin Medical Laboratories | Pathology | 3325 Chanate Rd, Santa Rosa, CA 95404-1707 | 2010-08-12 |
| 1447356811 | Marin Medical Laboratories | Pathology | 250 Bon Air Road, Greenbrae, CA 94904 | 2006-09-15 |
| 1336245653 | Marin Medical Laboratories | Nuclear Medicine | 180 Rowland Way, Novato, CA 94947 | 2006-09-15 |
| 1013025634 | Marin Medical Laboratories | Nuclear Medicine | 250 Bon Air Road, Greenbrae, CA 94904 | 2006-08-25 |
| Street Address |
250 BON AIR ROAD |
| City | GREENBRAE |
| State | CA |
| Zip Code | 94904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558479105 | Robert Cohen | Nuclear Medicine | 250 Bon Air Road, Greenbrae, CA 94904 | 2006-08-25 |
| 1467700245 | Sound Inpatient Physicians Medical Group, Inc. | Family Medicine | 250 Bon Air Road, Greenbrae, CA 94904 | 2012-08-27 |
| 1891999439 | Elsa O Ng | Marriage & Family Therapist | 250 Bon Air Road, Greenbrae, CA 94904 | 2007-06-14 |
| 1518173400 | Elizabeth Claire Nadiv | Pediatrics | 250 Bon Air Road, M691, Greenbrae, CA 94904 | 2007-05-15 |
| 1881746568 | Alexandra Beatriz Siliezar | Marriage & Family Therapist | 250 Bon Air Road, Greenbrae, CA 94904 | 2007-01-16 |
| 1871685578 | Susan Sun | Internal Medicine | 250 Bon Air Road, Greenbrae, CA 94984 | 2006-09-29 |
| 1447356811 | Marin Medical Laboratories | Pathology | 250 Bon Air Road, Greenbrae, CA 94904 | 2006-09-15 |
| 1013025634 | Marin Medical Laboratories | Nuclear Medicine | 250 Bon Air Road, Greenbrae, CA 94904 | 2006-08-25 |
| 1619085263 | Imok Cha | Pathology | 250 Bon Air Road, Greenbrae, CA 94904 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295382372 | Stacey Nicole Drew | Occupational Therapist | 4 Ash Ave, Unit 10, Kentfield, CA 94904 | 2019-08-22 |
| 1154781631 | Harvey Sparks | Specialist/Technologist, Other | 350 Bon Air, Ste 100, Greenbrae, CA 94904 | 2016-02-26 |
| 1396120481 | Tamena Potts | Counselor | 1109 Sir Francis Drake, Kentfield, CA 94904 | 2015-07-30 |
| 1598014763 | Rupali Ray Chaudhuri | Nurse Practitioner | 1341 S. Eliseo Dr, Suite 200, Greenbrae, CA 94904 | 2012-09-04 |
| 1326304809 | Lucy Yingxin Zhang | Ophthalmology | 900 S Eliseo Dr Ste 102, Greenbrae, CA 94904 | 2012-04-09 |
| 1396073185 | Bonnie Louise Hoag | Marriage & Family Therapist | 905 Sir Francis Drake Blvd., Ste. F., Kentfield, CA 94904 | 2009-12-07 |
| 1801043880 | Alexander Vogel Uihlein | Internal Medicine | 900 S Eliseo Dr Ste 201, Greenbrae, CA 94904 | 2008-08-21 |
| 1649426115 | Marilyn Thatcher | Psychologist | 1010 Sir Francis Drake Blve, Ste. 103, Kentfield, CA 94904 | 2008-08-14 |
| 1205007598 | Sir Francis Drake Dental | Dentist | 919 Sir Francis Drake Blvd, Kentfield, CA 94904 | 2008-03-14 |
| 1841401734 | Rishi K Wadhwa | Neurological Surgery | 1100 S Eliseo Dr Ste 1, Greenbrae, CA 94904 | 2007-05-24 |
| Find all providers in zip 94904 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356607121 | Christopher J Kim | Pathology | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2012-04-05 |
| 1497080568 | Amanda Doherty | Pathology | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2009-10-07 |
| 1528298338 | Nadia Naderi | Pathology | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2009-07-15 |
| 1346404308 | Menaka Raju | Pathology | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2008-07-17 |
| 1447356811 | Marin Medical Laboratories | Pathology | 250 Bon Air Road, Greenbrae, CA 94904 | 2006-09-15 |
| 1841308558 | Kedar Che Prasad | Pathology | 250 Bon Air Rd, Greenbrae, CA 94904 | 2006-08-25 |
| 1699883314 | Christopher John Jacques | Pathology | 250 Bon Air Rd, Greenbrae, CA 94904 | 2006-08-25 |
| 1619085263 | Imok Cha | Pathology | 250 Bon Air Road, Greenbrae, CA 94904 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063058170 | Paragon Diagnostics San Francisco | Pathology | 900 Hyde St Fl 1, San Francisco, CA 94109-4806 | 2019-11-24 |
| 1669034518 | Diagnostic Pathology Medical Group Inc | Pathology | 2801 K St Ste 235, Sacramento, CA 95816-5170 | 2019-07-01 |
| 1093277956 | Shajia Rahman Ansari | Pathology | 38558 Vancouver Cmn, Fremont, CA 94536-4056 | 2019-04-01 |
| 1831655158 | Rana Richeh | Pathology | 12 Spectrum Pointe Dr, Lake Forest, CA 92630-2242 | 2019-02-11 |
| 1710457510 | University of California Sfgh Medical Group | Pathology | 1001 Potrero Ave Rm 2m14, San Francisco, CA 94110-3518 | 2018-12-05 |
| 1770053233 | Samuel Jason Guzman | Pathology | 10026 Karmont Ave, South Gate, CA 90280-5417 | 2018-11-27 |
| 1144799750 | Penguin Medical Group, Inc | Pathology | 11 W Del Mar Blvd Ste 201, Pasadena, CA 91105-2593 | 2018-11-13 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| 1972080752 | Boris Shlopov Md Pathology Medical Corporation | Pathology | 800 S Main, Corona, CA 92882 | 2018-07-24 |
| 1902383920 | Ntr Resources, LLC | Pathology | 17433 Nordhoff, Northridge, CA 91325 | 2018-07-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.