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Contact Information

POTOMAC HEALTH MEDICAL OF CA PC
11 PIEDMONT ROAD
LARKSPUR, CA94939
 Phone: 860-282-4128
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
 

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for POTOMAC HEALTH MEDICAL OF CA PC

NPI Number 1417672437
LBN Legal business name POTOMAC HEALTH MEDICAL OF CA PC
Authorized official JAY KIMMEL - (PRESIDENT/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/12/2022
Last updated 11/17/2022 - About 4 years ago
Identifiers n/a
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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