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Organization
PRIMA MEDICAL FOUNDATION
Active
Organization
PRIMA MEDICAL FOUNDATION
Active
Parent organization
PRIMA MEDICAL FOUNDATION
Other names
Urgent Care Pediatric After Hours
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMA MEDICAL FOUNDATION
Authorized official
JOANNA RUBEL (SR. DIRECTOR OF PRACTICE OPERATIONS)
(415) 842-5103
Entity
Organization
Contact information
Practice address
1260 S. ELISEO DR, FLOOR 2, GREENBRAE, CA 94904-2009
(415) 924-1214
Mailing address
4 HAMILTON LANDING, SUITE 100, NOVATO, CA 94949
(415) 884-1840
(415) 884-3510
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A42149
CA
208000000X
Pediatrics Physician
G55637
CA
208600000X
Surgery Physician
A65187
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ03538Z
MEDICARE PTAN
CA
Enumeration date
07/15/2008
Last updated
07/18/2015
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