PRIMA MEDICAL FOUNDATION (NPI# 1073892717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073892717 |
| Entity Type | Organization |
| Organization Name | PRIMA MEDICAL FOUNDATION |
| Practice Address |
1350 S Eliseo Dr #210 Greenbrae CA 94904-2011 |
| Mailing Address |
4 Hamilton Lndg Suite 100 Novato CA 94949-8256 |
| Practice Telephone | 4159255035 |
| Mailing Telephone | 4158841840 |
| Mailing Fax Number | 4158843510 |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2012-07-24 |
| Authorized Official Name | MR. JOEL A. CRISTE (CEO) |
| Authorized Official Telephone | 4158841840 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRIMA MEDICAL FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | A89531 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN | ZZZ03538Z | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609157734 | Prima Medical Foundation | Surgery | 100 A Drakes Landing Rd, Suite 225, Greenbrae, CA 94904-3119 | 2011-09-02 |
| 1811217946 | Prima Medical Foundation | Clinic/Center | 4 Hamilton Landing, Suite 100, Novato, CA 94949 | 2010-06-11 |
| 1396909735 | Prima Medical Foundation | Pediatrics | 1260 S. Eliseo Dr, Floor 2, Greenbrae, CA 94904-2009 | 2008-07-15 |
| 1437313863 | Prima Medical Foundation | General Practice | 651 1st Street West, Suite H, Sonoma, CA 95476 | 2008-07-15 |
| 1548258106 | Prima Medical Foundation | General Practice | 1260 S Eliseo Dr, Floor 2, Greenbrae, CA 94904-2009 | 2005-10-07 |
| 1033503446 | Prima Medical Foundation | Obstetrics & Gynecology | 75 Rowland Way, Suite 275, Novato, CA 94945-5037 | 2015-03-24 |
| 1902244528 | Prima Medical Foundation | General Practice | 652 Petaluma Ave, Suite H, Sebastopol, CA 95472-4256 | 2013-06-05 |
| 1902187560 | Prima Medical Foundation | Orthopaedic Surgery | 651 1st St W, Suite K, Sonoma, CA 95476-7045 | 2011-09-08 |
| 1649551201 | Prima Medical Foundation | Orthopaedic Surgery | 651 1st St W, Suite K, Sonoma, CA 95476-7045 | 2011-09-08 |
| 1548541105 | Prima Medical Foundation | Surgery | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2011-09-08 |
| Street Address |
1350 S ELISEO DR #210 |
| City | GREENBRAE |
| State | CA |
| Zip Code | 94904-2011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225037500 | John Bettinger | Internal Medicine | 1350 S Eliseo Dr, Ste 130, Greenbrae, CA 94904-2011 | 2005-07-19 |
| 1679127716 | Crystal Ann Brierton | Speech-Language Pathologist | 1350 S Eliseo Dr, Greenbrae, CA 94904-2011 | 2019-07-26 |
| 1841705399 | David Fonseca Tapia | Emergency Medical Technician, Basic | 1350 S Eliseo Dr, Greenbrae, CA 94904-2011 | 2017-12-06 |
| 1538595905 | Julie Ilene Nicholson | Counselor | 1350 S Eliseo Dr, Suite 220, Greenbrae, CA 94904-2011 | 2013-09-17 |
| 1205271483 | Laury Rappaport | Marriage & Family Therapist | 1350 S Eliseo Dr, Suite 120, Greenbrae, CA 94904-2011 | 2013-05-01 |
| 1407192438 | Amy Jeanne Holm | Nurse Practitioner | 1350 S Eliseo Dr, Suite 130, Greenbrae, CA 94904-2011 | 2012-12-19 |
| 1801172598 | Melissa Ovalles Tejada | Nurse Practitioner | 1350 S Eliseo Dr, Suite 130, Greenbrae, CA 94904-2011 | 2011-10-26 |
| 1629370499 | Marin Cancer Care, Inc. | Radiology | 1350 S Eliseo Dr, Suite 200, Greenbrae, CA 94904-2011 | 2010-11-29 |
| 1376867010 | Christopher Hogan | Internal Medicine | 1350 S Eliseo Dr, Suite 130, Greenbrae, CA 94904-2011 | 2010-03-24 |
| 1346497658 | Kirsten Wilson Ellis | Nurse Practitioner | 1350 S Eliseo Dr, Ste 130, Greenbrae, CA 94904-2011 | 2008-08-19 |
| Find all providers in the same location | ||||
| 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 | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609157734 | Prima Medical Foundation | Surgery | 100 A Drakes Landing Rd, Suite 225, Greenbrae, CA 94904-3119 | 2011-09-02 |
| 1679714174 | Arthur C. Fenn & Romeo C. Agbayani Md Ptr | Surgery | 1000 S Eliseo Dr Ste 103, Greenbrae, CA 94904-2150 | 2009-03-12 |
| 1548541105 | Prima Medical Foundation | Surgery | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2011-09-08 |
| 1508007535 | Marin Surgical Associates | Surgery | 1300 S Eliseo Dr, Greenbrae, CA 94904-2023 | 2009-03-21 |
| 1326128265 | Zakhireh Inc | Surgery | 1363 S Eliseo Dr, Suite A, Greenbrae, CA 94904-2012 | 2006-10-16 |
| 1548340474 | Mohammed Ali Zakhireh | Surgery | 1363 S Eliseo Dr, Suite A, Greenbrae, CA 94904-2012 | 2006-10-16 |
| 1902908288 | Noor Saba Azimi | Surgery | 1300 S Eliseo Dr, #203, Greenbrae, CA 94904-2023 | 2006-09-05 |
| 1972515971 | Ann L Vercoutere | Surgery | 1363 S Eliseo Dr, Suite A, Greenbrae, CA 94904-2012 | 2006-08-12 |
| 1831130863 | Mark Arthur Peterson | Surgery | 1300 S Eliseo Dr, Ste 104, Greenbrae, CA 94904-2023 | 2006-06-09 |
| 1356305866 | John Maa | Surgery | 250 Bon Air Rd, Greenbrae, CA 94904-1702 | 2006-04-12 |
| Find all providers in GREENBRAE | ||||
Please comment or provide details below to improve the information on PRIMA MEDICAL FOUNDATION.
| 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.