Organization
MARIN MEDICAL LABORATORIES
Active
Other names
Marin Medical Laboratories Marin General Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEDAR CHE PRASAD MD (PATHOLOGIST)
(415) 209-6017
Entity
Organization
Contact information
Practice address
250 BON AIR ROAD, GREENBRAE, CA 94904
(415) 925-7174
(415) 461-7228
Mailing address
1615 HILL ROAD SUITE B, NOVATO, CA 94947
(415) 209-6983
(415) 898-0870
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
CLF316040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB00787F
—
CA
Enumeration date
09/15/2006
Last updated
08/11/2022
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