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Organization
MARIN HEALTHCARE DISTRICT
Active
Organization
MARIN HEALTHCARE DISTRICT
Active
Other names
Soluna Sausalito Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
LEE DOMANICO (CEO)
(415) 464-2090
Entity
Organization
Contact information
Practice address
111 SECOND ST, SAUSALITO, CA 94965-2526
(415) 332-2600
(415) 332-2610
Mailing address
100 DRAKES LANDING RD # B, SUITE 250, GREENBRAE, CA 94904-2404
(415) 464-2090
(415) 464-2094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS440A
MEDICARE GROUP PTAN
CA
Enumeration date
02/13/2012
Last updated
02/13/2012
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