# PRIMA MEDICAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRIMA MEDICAL FOUNDATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1649551201
- **Legal business name:** PRIMA MEDICAL FOUNDATION
- **Authorized official:** MR. JOEL A. CRISTE (CEO)
- **Authorized official phone:** (415) 884-1840

## Contact information

- **Practice address:** 651 1ST ST W, SUITE K, SONOMA, CA 95476-7045
- **Practice address phone:** (707) 938-3870
- **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 | G88678 | CA | Yes |

## Other

- **Enumeration date:** 09/08/2011
- **Last updated:** 07/24/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | ZZZ03538Z | MEDICARE PTAN | CA |