Organization
PRIMA MEDICAL FOUNDATION SEBASTOPOL
Active
Parent organization
PRIMA MEDICAL FOUNDATION
Other names
Prima Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMA MEDICAL FOUNDATION
Authorized official
DENNIS MONDRAGON (COO)
(415) 884-1840
Entity
Organization
Contact information
Practice address
652 PETALUMA AVE, SUITE H, SEBASTOPOL, CA 95472-4256
(707) 823-7616
(707) 823-2803
Mailing address
4 HAMILTON LNDG STE 100, NOVATO, CA 94949-8247
(415) 884-1840
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
02/26/2008
Last updated
04/24/2013
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