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Contact Information

PRIMA MEDICAL FOUNDATION
655 REDWOOD HIGHWAY
SUITE 216
MILL VALLEY, CA94941
 Phone: 415-383-3500
 Fax: 415-383-3554
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PRIMA MEDICAL FOUNDATION · (Female)

NPI Number 1366606766
Status Active
Credentials
Entity Individual
Enumeration date 07/15/2008
Last updated 08/31/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • CA License # A65187
  • CA License # A77821
  • CA License # G55637
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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