# MARIN MEDICAL LABORATORIES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326444647
- **Authorized official:** DR. KEDAR CHE PRASAD MD (PATHOLOGIST)
- **Authorized official phone:** (415) 209-6983

## Contact information

- **Practice address:** 1165 MONTGOMERY DR, SANTA ROSA, CA 95405-4801
- **Practice address phone:** (707) 525-5352
- **Practice address fax:** (707) 522-1535
- **Mailing address:** 1615 HILL RD STE B, NOVATO, CA 94947-4338
- **Mailing address phone:** (415) 898-7649
- **Mailing address fax:** (415) 898-0870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | CLF 00001292 | CA | Yes |

## Other

- **Enumeration date:** 11/13/2014
- **Last updated:** 08/11/2022