Organization
MARIN MEDICAL LABORATORIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEDAR CHE PRASAD MD (PATHOLOGIST)
(415) 209-6983
Entity
Organization
Contact information
Practice address
1165 MONTGOMERY DR, SANTA ROSA, CA 95405-4801
(707) 525-5352
(707) 522-1535
Mailing address
1615 HILL RD STE B, NOVATO, CA 94947-4338
(415) 898-7649
(415) 898-0870
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
CLF 00001292
CA
Other
Enumeration date
11/13/2014
Last updated
08/11/2022
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