PRIMA MEDICAL FOUNDATION (NPI# 1548258106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548258106 |
Entity Type | Organization |
Organization Name | PRIMA MEDICAL FOUNDATION |
Practice Address |
1260 S Eliseo Dr Floor 2 Greenbrae CA 94904-2009 |
Mailing Address |
9 Commercial Blvd Suite 200 Novato CA 94949-6118 |
Practice Telephone | 4154617800 |
Practice Fax Number | 4159241375 |
Mailing Telephone | 4158425000 |
Enumeration Date | 2005-10-07 |
Last Update Date | 2015-08-13 |
Authorized Official Name | JOANNA RUBEL (SR. DIRECTOR OF PRACTICE OPERATIONS) |
Authorized Official Telephone | 4158425103 |
Is Organization Subpart | Y |
Parent Organization Name | PRIMA MEDICAL FOUNDATION |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
G88295 | CA | Allopathic & Osteopathic Physicians |
N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
G45217 | CA | Allopathic & Osteopathic Physicians |
Y | 208D00000X | General Practice | A72388 | CA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CA | MEDICARE | 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 |
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 |
1639450299 | Prima Medical Foundation | Internal Medicine | 75 Rowland Way, #100, Novato, CA 94945-5037 | 2011-09-08 |
Street Address |
1260 S ELISEO DR FLOOR 2 |
City | GREENBRAE |
State | CA |
Zip Code | 94904-2009 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477892099 | Marin Magnetic Resonance Imaging Center, LLC | Clinic/Center | 1260 S Eliseo Dr, Suite 101, Greenbrae, CA 94904-2009 | 2013-02-01 |
1386956498 | Robin Litt | Nurse Practitioner | 1260 S Eliseo Dr, Greenbrae, CA 94904-2009 | 2010-07-06 |
1588815534 | Mary Newberry Davis | Advanced Practice Midwife | 1260 S Eliseo Dr, Floor 2, Greenbrae, CA 94904-2009 | 2008-10-08 |
1053587667 | Cortney Harper | Obstetrics & Gynecology | 1260 S Eliseo Dr, Floor 2, Greenbrae, CA 94904-2009 | 2008-05-03 |
1528230570 | Prima Medical Group, Inc. | Non-Pharmacy Dispensing Site | 1260 S Eliseo Dr, Greenbrae, CA 94904-2009 | 2008-03-31 |
1285730275 | Gerald P Wilner | Obstetrics & Gynecology | 1260 S Eliseo Dr, Floor 2, Greenbrae, CA 94904-2009 | 2006-09-16 |
1790795599 | Women's Medical Associates | Obstetrics & Gynecology | 1260 S Eliseo Dr, Greenbrae, CA 94904-2009 | 2006-08-08 |
1154392637 | David B. Galland | Obstetrics & Gynecology | 1260 S Eliseo Dr, Floor 2, Greenbrae, CA 94904-2009 | 2006-01-31 |
1770553950 | Brian E Demuth | Obstetrics & Gynecology | 1260 S Eliseo Dr, Floor 2, Greenbrae, CA 94904-2009 | 2006-01-23 |
1720065949 | Monica Lopez | Obstetrics & Gynecology | 1260 S Eliseo Dr, Greenbrae, CA 94904-2009 | 2005-12-29 |
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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 | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336312370 | Robert F. Shaw | General Practice | 336 Bon Air Ctr # 407, Greenbrae, CA 94904-3017 | 2008-04-10 |
1235238791 | Martin Lester Rossman | General Practice | 1341 S Eliseo Dr Ste 350, Greenbrae, CA 94904-2000 | 2006-09-21 |
1124310636 | Martin L. Rossman, M.d., A Professional Corporation | General Practice | 1341 S Eliseo Dr, Suite 350, Greenbrae, CA 94904-2000 | 2011-05-03 |
1013031913 | Janet Bodle | General Practice | 100a Drake's Landing Road, Suite 225, Greenbrae, CA 94904-3032 | 2007-03-17 |
1255447330 | James Conrad Gardner | General Practice | 599 Sir Francis Drake Blvd, Ste. # 203, Greenbrae, CA 94904-1712 | 2006-08-22 |
1982666764 | Flash Gordon | General Practice | 1000 S Eliseo Dr, Ste 204, Greenbrae, CA 94904-2133 | 2006-04-05 |
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1376156109 | Gtl Medical Group Inc | General Practice | 14555 Hamlin St Ste 107, Van Nuys, CA 91411-1617 | 2020-08-31 |
1922611896 | Daniel Lynn Johnson | General Practice | 74075 El Paseo Ste B2, Palm Desert, CA 92260-4118 | 2020-08-28 |
1235755299 | Hofmeister Medical, PC | General Practice | 31735 Riverside Dr Ste K, Lake Elsinore, CA 92530-7816 | 2020-06-24 |
1033733779 | South Bay Regenerative Medical Spa Inc | General Practice | 412 S Pacific Coast Hwy Ste 100, Redondo Beach, CA 90277-3712 | 2020-05-28 |
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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.