# PRIMA MEDICAL FOUNDATION

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

## Provider details

- **NPI number:** 1639366586
- **Authorized official:** DENNIS MONDRAGON (CEO)
- **Authorized official phone:** (415) 884-1840

## Contact information

- **Practice address:** 165 ROWLAND WAY STE 100, NOVATO, CA 94945-5055
- **Practice address phone:** (415) 898-4211
- **Practice address fax:** (415) 898-9252
- **Mailing address:** 4 HAMILTON LNDG, SUITE 100, NOVATO, CA 94949-8256
- **Mailing address phone:** (415) 884-1840
- **Mailing address fax:** (415) 884-3510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G30247 | CA | Yes |

## Other

- **Enumeration date:** 09/25/2007
- **Last updated:** 08/01/2012