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Organization
LIFELONG MEDICAL CARE
Active
Organization
LIFELONG MEDICAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTY LYNCH (CEO)
(510) 981-4100
Entity
Organization
Contact information
Practice address
1424 JEFFERSON ST, OAKLAND, CA 94612-1972
(510) 981-4136
Mailing address
2344 6TH ST, BERKELEY, CA 94710-2412
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70474G
—
CA
Enumeration date
03/10/2014
Last updated
03/10/2014
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