Organization
PRIMA MEDICAL FOUNDATION
Active
Parent organization
PRIMA MEDICAL FOUNDATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMA MEDICAL FOUNDATION
Authorized official
MR. JOEL A. CRISTE (CEO)
(415) 884-1840
Entity
Organization
Contact information
Practice address
1350 S ELISEO DR, #210, GREENBRAE, CA 94904-2011
(415) 925-5035
Mailing address
4 HAMILTON LNDG, SUITE 100, NOVATO, CA 94949-8256
(415) 884-1840
(415) 884-3510
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A89531
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ03538Z
MEDICARE PTAN
CA
Enumeration date
08/11/2011
Last updated
07/24/2012
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