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Organization
LIFELONG MEDICAL CARE
Active
Organization
LIFELONG MEDICAL CARE
Active
Other names
BERKELEY PRIMARY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTY LYNCH N/A (CEO)
(510) 981-4100
Entity
Organization
Contact information
Practice address
2001 DWIGHT WAY, RM 1363, BERKELEY, CA 94704-2608
(510) 204-4666
Mailing address
PO BOX 11247, BERKELEY, CA 94712-2247
(510) 981-4100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
140000372
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70474G
—
CA
01
—
HAP70474G
FAMILY PACT
CA
Enumeration date
06/23/2005
Last updated
10/23/2009
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