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Organization
MARIN HEALTHCARE DISTRICT
Active
Organization
MARIN HEALTHCARE DISTRICT
Active
Other names
North Marin Internal Medicine Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
LEE DOMANICO (CEO)
(415) 464-2090
Entity
Organization
Contact information
Practice address
165 ROWLAND WAY, SUITE 201, NOVATO, CA 94945-5038
(415) 897-3174
(415) 892-9589
Mailing address
PO BOX 45094, SAN FRANCISCO, CA 94145-0094
(415) 464-2090
(415) 464-2094
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS440A
MEDICARE GROUP PTAN
CA
Enumeration date
02/10/2012
Last updated
10/31/2013
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