Organization
MARIN CITY HEALTH AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYVON MUHAMMAD (CHIEF EXECUTIVE OFFICER)
(415) 339-8813
Entity
Organization
Contact information
Practice address
880 LAS GALLINAS AVE, SUITE 2, SAN RAFAEL, CA 94903
(415) 339-8813
Mailing address
630 DRAKE AVE, SAUSALITO, CA 94965-1107
(415) 339-8813
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
55000861
CA
Other
Enumeration date
05/11/2017
Last updated
07/11/2018
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