| Prima Medical Foundation | |
|
4 Hamilton Landing Suite 100 Novato CA 94949 | |
| (415) 884-1840 | |
| (415) 884-3510 |
| Full Name | Prima Medical Foundation |
|---|---|
| Speciality | Clinic/Center |
| Location | 4 Hamilton Landing, Novato, California |
| Authorized Official Name and Position | Joel A Criste (CEO) |
| Authorized Official Contact | 4158841840 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prima Medical Foundation 4 Hamilton Landing Suite 100 Novato CA 94949 Ph: (415) 884-1840 | Prima Medical Foundation 4 Hamilton Landing Suite 100 Novato CA 94949 Ph: (415) 884-1840 |
| NPI Number | 1811217946 |
|---|---|
| Provider Enumeration Date | 06/11/2010 |
| Last Update Date | 08/14/2012 |
| Medicare PECOS PAC ID | 6406040138 |
|---|---|
| Medicare Enrollment ID | O20101027000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811217946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Merrill Ralph Nisam |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1205824067 PECOS PAC ID: 7214836857 Enrollment ID: I20040102000689 |
| Provider Name | Robert Lee Newbury |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528086287 PECOS PAC ID: 5193626620 Enrollment ID: I20040117000183 |
| Provider Name | Russell C Fritz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679550032 PECOS PAC ID: 1456259662 Enrollment ID: I20040309000390 |
| Provider Name | Betsy Holland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659357481 PECOS PAC ID: 8729986930 Enrollment ID: I20040309001055 |
| Provider Name | Jay A Kaiser |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275519001 PECOS PAC ID: 1355249566 Enrollment ID: I20040309001089 |
| Provider Name | Eric David Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376599191 PECOS PAC ID: 1951299023 Enrollment ID: I20040309001280 |
| Provider Name | Donna Hoghooghi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295781201 PECOS PAC ID: 4486646569 Enrollment ID: I20040330001847 |
| Provider Name | Jana M Crain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376597716 PECOS PAC ID: 0446152946 Enrollment ID: I20040413001867 |
| Provider Name | Damon Sacco |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700862539 PECOS PAC ID: 1355242694 Enrollment ID: I20040426000476 |
| Provider Name | Raymond M Bonneau |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790866283 PECOS PAC ID: 2163419425 Enrollment ID: I20040428000890 |
| Provider Name | Sareena Chopra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487670832 PECOS PAC ID: 6103814207 Enrollment ID: I20040505001781 |
| Provider Name | Terri L Turner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366522831 PECOS PAC ID: 9830188671 Enrollment ID: I20040507000904 |
| Provider Name | Kirsten Jennifer Voss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740267939 PECOS PAC ID: 7911980636 Enrollment ID: I20040611001073 |
| Provider Name | Alan H Le |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992884647 PECOS PAC ID: 9739163544 Enrollment ID: I20040617000672 |
| Provider Name | Brian E Demuth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770553950 PECOS PAC ID: 7719962844 Enrollment ID: I20040623000712 |
| Provider Name | Christopher J Yoo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295776672 PECOS PAC ID: 4789651530 Enrollment ID: I20040913000441 |
| Provider Name | Janaki Ramanathan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275611873 PECOS PAC ID: 9931178837 Enrollment ID: I20040928000541 |
| Provider Name | Gregg Leonard Tolliver |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346286465 PECOS PAC ID: 0446211304 Enrollment ID: I20041023000118 |
| Provider Name | Crystine M Lee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508853896 PECOS PAC ID: 1658337043 Enrollment ID: I20041207001084 |
| Provider Name | Joseph Antoin Habis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760439681 PECOS PAC ID: 9032177761 Enrollment ID: I20041228000991 |
| Provider Name | Sheri Ann Matteo |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1538216890 PECOS PAC ID: 8325097355 Enrollment ID: I20050118000286 |
| Provider Name | Lisa R De La Fuente |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1023038130 PECOS PAC ID: 2769429646 Enrollment ID: I20050412001069 |
| Provider Name | Sally E Boero |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285731703 PECOS PAC ID: 8729021977 Enrollment ID: I20050608000432 |
| Provider Name | Elizabeth L Etemad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881682458 PECOS PAC ID: 7113953183 Enrollment ID: I20050711000864 |
| Provider Name | Cheri Forrester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841237153 PECOS PAC ID: 8820024763 Enrollment ID: I20050712001257 |
| Provider Name | Fiona V Henderson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063506962 PECOS PAC ID: 2163451907 Enrollment ID: I20050811000517 |
| Provider Name | Isabelle King |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790714319 PECOS PAC ID: 3476585258 Enrollment ID: I20050831000867 |
| Provider Name | Brian Sebastian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184624637 PECOS PAC ID: 5991602906 Enrollment ID: I20050901000435 |
| Provider Name | John M Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306836366 PECOS PAC ID: 4880611714 Enrollment ID: I20051028001020 |
| Provider Name | Robert L Wirth |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396786547 PECOS PAC ID: 8123042355 Enrollment ID: I20060114000115 |
| Provider Name | Ralph M Koenker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891734265 PECOS PAC ID: 4789582909 Enrollment ID: I20060209000255 |
| Provider Name | Meenal S Lohtia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205883121 PECOS PAC ID: 0840209128 Enrollment ID: I20060413000634 |
| Provider Name | Kristen Marxen Matsik |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295807022 PECOS PAC ID: 8921018912 Enrollment ID: I20060504000914 |
| Provider Name | Malini A Nijagal |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043322233 PECOS PAC ID: 4688777188 Enrollment ID: I20070320000702 |
| Provider Name | Hector C Streeter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124190202 PECOS PAC ID: 3173628856 Enrollment ID: I20070425000446 |
| Provider Name | Barbara D Finzen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134225352 PECOS PAC ID: 6507962552 Enrollment ID: I20070508000269 |
| Provider Name | Jean Pierre Phancao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215054416 PECOS PAC ID: 9830298744 Enrollment ID: I20070618000442 |
| Provider Name | Natalya M Lvoff |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164549630 PECOS PAC ID: 0941391643 Enrollment ID: I20070809000679 |
| Provider Name | Derek A Burdeny |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235208638 PECOS PAC ID: 2264454289 Enrollment ID: I20071025000184 |
| Provider Name | Leah M Kelley |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1013043314 PECOS PAC ID: 3375632722 Enrollment ID: I20071207000573 |
| Provider Name | Lawrence Posner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952390098 PECOS PAC ID: 4587688924 Enrollment ID: I20080206000277 |
| Provider Name | John Maa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356305866 PECOS PAC ID: 1850475963 Enrollment ID: I20080228000201 |
| Provider Name | Dennis S Orwig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144267097 PECOS PAC ID: 4880592005 Enrollment ID: I20080313000291 |
| Provider Name | Giovanni Elia |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1215016878 PECOS PAC ID: 5092891515 Enrollment ID: I20080325000237 |
| Provider Name | Adam W Nevitt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811934797 PECOS PAC ID: 4587679238 Enrollment ID: I20080710000606 |
| Provider Name | Zarlasht Fakiri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821265448 PECOS PAC ID: 1557420833 Enrollment ID: I20081030000824 |
| Provider Name | Philip S Kurzman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346424991 PECOS PAC ID: 5597817965 Enrollment ID: I20090715000588 |
| Provider Name | Scott V Perryman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083800999 PECOS PAC ID: 3678626629 Enrollment ID: I20090808000030 |
| Provider Name | Alice Yee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194985879 PECOS PAC ID: 3971640392 Enrollment ID: I20091016000310 |
| Provider Name | Anjuli Basu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679583579 PECOS PAC ID: 9830236421 Enrollment ID: I20091030000527 |
| Provider Name | Amelia G Baurmann |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1821245952 PECOS PAC ID: 0941349880 Enrollment ID: I20091205000107 |
| Provider Name | Yamilee O Bermingham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013937127 PECOS PAC ID: 0143360503 Enrollment ID: I20091215000401 |
| Provider Name | Mary Newberry Davis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1588815534 PECOS PAC ID: 1355481763 Enrollment ID: I20091216000141 |
| Provider Name | Danielle Walker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306976261 PECOS PAC ID: 6204820590 Enrollment ID: I20100108000259 |
| Provider Name | Sylvia J Flores |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114904307 PECOS PAC ID: 6305999343 Enrollment ID: I20100216000314 |
| Provider Name | Gerald P Wilner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285730275 PECOS PAC ID: 3678653243 Enrollment ID: I20100226000578 |
| Provider Name | Michael A Singer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700806957 PECOS PAC ID: 0345379046 Enrollment ID: I20100518000452 |
| Provider Name | Alexander Evens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114144649 PECOS PAC ID: 8628100096 Enrollment ID: I20100720001031 |
| Provider Name | Michael Brown |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942286562 PECOS PAC ID: 3274423116 Enrollment ID: I20100819000845 |
| Provider Name | John D Andrew |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841220209 PECOS PAC ID: 0547385015 Enrollment ID: I20100921000868 |
| Provider Name | David Galland |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154392637 PECOS PAC ID: 4587744149 Enrollment ID: I20101004000686 |
| Provider Name | Alexis A Cardellini |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922242858 PECOS PAC ID: 7618156217 Enrollment ID: I20110128000423 |
| Provider Name | Doreen T Marino |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295934081 PECOS PAC ID: 9436241544 Enrollment ID: I20110622000629 |
| Provider Name | Edward Alfrey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992773311 PECOS PAC ID: 8921027913 Enrollment ID: I20110921000322 |
| Provider Name | Jerome C Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295708675 PECOS PAC ID: 4385818426 Enrollment ID: I20111129000487 |
| Provider Name | Lakshminarayan Srinivasan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174766802 PECOS PAC ID: 1355502527 Enrollment ID: I20120416000151 |
| Provider Name | Rita Gidwaney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528334877 PECOS PAC ID: 4880857788 Enrollment ID: I20120511000212 |
| Provider Name | Sarah L Chow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447557525 PECOS PAC ID: 7517122393 Enrollment ID: I20120628000372 |
| Provider Name | Nushrat Jahan Ullah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205071222 PECOS PAC ID: 8729125679 Enrollment ID: I20120727000340 |
| Provider Name | Sujatha D Pathi |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1639353279 PECOS PAC ID: 7517018278 Enrollment ID: I20121005000219 |
| Provider Name | James G Minnis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417169954 PECOS PAC ID: 4284883141 Enrollment ID: I20121009000560 |
| Provider Name | Selamawit Tarekegn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134362387 PECOS PAC ID: 4981841376 Enrollment ID: I20130819000103 |
| Provider Name | Aja Mauer-finkel Morningstar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972828952 PECOS PAC ID: 1850526393 Enrollment ID: I20131108001155 |
| Provider Name | Cortney E Harper |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053587667 PECOS PAC ID: 1759517345 Enrollment ID: I20131204002143 |
| Provider Name | Amber Jaeger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326281023 PECOS PAC ID: 9032342381 Enrollment ID: I20140512001961 |
| Provider Name | Allison C Paine |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073857439 PECOS PAC ID: 2466676978 Enrollment ID: I20140623002741 |
| Provider Name | Jennifer E Byer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578838298 PECOS PAC ID: 3971731290 Enrollment ID: I20140811000519 |
| Provider Name | Loree Skidmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346453297 PECOS PAC ID: 8628393014 Enrollment ID: I20150205001417 |
| Provider Name | Tomas Kubrican |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770751174 PECOS PAC ID: 7810041068 Enrollment ID: I20150423000069 |
| Provider Name | Dinah M Bukowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639261530 PECOS PAC ID: 6406742378 Enrollment ID: I20150428001462 |
| Provider Name | Lisa L Chu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134448137 PECOS PAC ID: 8426379538 Enrollment ID: I20150601002928 |
| Provider Name | Elizabeth R Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215281019 PECOS PAC ID: 5193945293 Enrollment ID: I20150807015014 |
| Provider Name | Benjamin N King |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285654202 PECOS PAC ID: 6204142318 Enrollment ID: I20150904000309 |
| Provider Name | Nicolae Tudorica |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801022926 PECOS PAC ID: 3577870864 Enrollment ID: I20150918001569 |
| Provider Name | Lori Katnik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124499413 PECOS PAC ID: 1557661436 Enrollment ID: I20151125000614 |
| Provider Name | Elizabeth Tong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932495496 PECOS PAC ID: 5698903524 Enrollment ID: I20160706001747 |
| Provider Name | Crystal Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518253012 PECOS PAC ID: 9436444163 Enrollment ID: I20160819001770 |
| Provider Name | Nicholas Alexander Telischak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629244850 PECOS PAC ID: 2163718925 Enrollment ID: I20160906000861 |
| Provider Name | Benjamin Stahl |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760771901 PECOS PAC ID: 5890082523 Enrollment ID: I20160923001945 |
| Provider Name | Carolyn Hwang |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1588033054 PECOS PAC ID: 0749581700 Enrollment ID: I20161216002096 |
| Provider Name | Nadine Aldahhan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609202308 PECOS PAC ID: 6901024009 Enrollment ID: I20170116000677 |
| Provider Name | Mazen Hariri |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1740628213 PECOS PAC ID: 1850526831 Enrollment ID: I20170124001745 |
| Provider Name | Rajdeep Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104368778 PECOS PAC ID: 7719260249 Enrollment ID: I20170208000736 |
| Provider Name | Neil Hemant Thakur |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053609602 PECOS PAC ID: 1153606512 Enrollment ID: I20170327001405 |
| Provider Name | Ari Kane |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285924290 PECOS PAC ID: 1355631185 Enrollment ID: I20170717001864 |
| Provider Name | Rachel Elisabeth Ely-konoske |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1447763867 PECOS PAC ID: 6002178696 Enrollment ID: I20180319002350 |
| Provider Name | Melanie Staehelin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588167563 PECOS PAC ID: 4981966447 Enrollment ID: I20180320003461 |
| Provider Name | Lindsay P Busby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215379144 PECOS PAC ID: 3779847967 Enrollment ID: I20180516002353 |
| Provider Name | Steven K Kwong |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689051997 PECOS PAC ID: 4385999648 Enrollment ID: I20180611001115 |
| Provider Name | Bernard Brass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871941013 PECOS PAC ID: 5890040331 Enrollment ID: I20180625000697 |
| Provider Name | Marin Alisa Mcdonald |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861734212 PECOS PAC ID: 7012263031 Enrollment ID: I20180705002340 |
| Provider Name | Kelly R. Lindauer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417041153 PECOS PAC ID: 7911943378 Enrollment ID: I20180918002139 |
| Provider Name | Henry Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386062875 PECOS PAC ID: 3274861539 Enrollment ID: I20190823001835 |
| Provider Name | John Benjamin Colby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700205374 PECOS PAC ID: 9931520194 Enrollment ID: I20200527000629 |
| Provider Name | Peter M Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427460096 PECOS PAC ID: 2668700063 Enrollment ID: I20200716001163 |
| Provider Name | Keegan Kristin Hovis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336533991 PECOS PAC ID: 6204129489 Enrollment ID: I20210512001843 |
Marin Community Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6100 Redwood Blvd, Novato, CA 94945 Phone: 415-448-1500 Fax: 415-798-3198 | |
Matrix Parent Netwrok And Resource Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 94 Galli Dr, Suite C, Novato, CA 94949 Phone: 415-884-3535 | |
N/a Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1324 Grant Ave, Novato, CA 94945 Phone: 415-892-3300 Fax: 415-897-0079 | |
Glutality Provider Group Of California Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7250 Redwood Blvd Ste 300, Novato, CA 94945 Phone: 561-678-2026 Fax: 561-423-9249 | |
Veterans Administration Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 Lavenham Rd, Novato, CA 94949 Phone: 415-218-1435 | |
Novato Internal Medicine Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 165 Rowland Way, Suite 201, Novato, CA 94945 Phone: 415-897-3174 Fax: 415-892-9589 | |
Aspire Hospitalist Management Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 165 Rowland Way, Novato, CA 94945 Phone: 415-990-7901 |