| Marin Personalized Medicine, Inc. | |
|
895 Sir Francis Drake Blvd San Anselmo CA 94960-1916 | |
| (415) 925-3617 | |
| Not Available |
| Full Name | Marin Personalized Medicine, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 895 Sir Francis Drake Blvd, San Anselmo, California |
| Authorized Official Name and Position | David L Ogden (OWNER/PROVIDER) |
| Authorized Official Contact | 4159253596 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marin Personalized Medicine, Inc. 895 Sir Francis Drake Blvd San Anselmo CA 94960-1916 Ph: (415) 925-3617 | Marin Personalized Medicine, Inc. 895 Sir Francis Drake Blvd San Anselmo CA 94960-1916 Ph: (415) 925-3617 |
| NPI Number | 1780025361 |
|---|---|
| Provider Enumeration Date | 07/11/2013 |
| Last Update Date | 10/14/2021 |
| Medicare PECOS PAC ID | 3779997911 |
|---|---|
| Medicare Enrollment ID | O20210128002043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780025361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Primary |
| Provider Name | David L Ogden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003887324 PECOS PAC ID: 7214923986 Enrollment ID: I20140722002753 |
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