Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
MARIN EMERGENCY PHYSICIANS MEDICAL GROUP, INC.
Active
Organization
MARIN EMERGENCY PHYSICIANS MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD BODONY MD (MEDICAL DIRECTOR)
(415) 209-1300
Entity
Organization
Contact information
Practice address
180 ROWLAND WAY, NOVATO, CA 94945-5009
(415) 209-1300
(415) 209-1351
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(818) 340-9988
(818) 444-7214
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0505346
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0086760
—
CA
01
—
ZZZ64077Z
BLUE SHIELD
CA
Enumeration date
11/22/2005
Last updated
07/21/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up