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Contact Information

PRIMA MEDICAL GROUP-TERRA LINDA
4000 CIVIC CENTER DRIVE
SUITE 200B
SAN RAFAEL, CA94903
 Phone: 415-492-3333
 Fax: 415-492-3425
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Multi-Specialty

261QM1300X 70 Clinic or Group Practice
Indicates primary specialty

NPI Profile & details for PRIMA MEDICAL GROUP-TERRA LINDA

NPI # 1730463258
LBN Legal business name PRIMA MEDICAL GROUP-TERRA LINDA
Authorized official JOEL CRISTE - (CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 10/03/2011
Last updated 08/14/2012 - About 14 years ago
Identifiers
CA License # G55637
CA License # G73451
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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