N/a | |
1324 Grant Ave Novato CA 94945-3152 | |
(415) 892-3300 | |
(415) 897-0079 |
Full Name | N/a |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 1324 Grant Ave, Novato, California |
Authorized Official Name and Position | John Elloway (DIRECTOR) |
Authorized Official Contact | 4158923300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
N/a 1324 Grant Ave Novato CA 94945-3152 Ph: (415) 892-3300 | N/a 1324 Grant Ave Novato CA 94945-3152 Ph: (415) 892-3300 |
NPI Number | 1174794770 |
---|---|
Provider Enumeration Date | 03/21/2008 |
Last Update Date | 11/15/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174794770 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | ZZZ24941Z (California) | Primary |
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