Organization
MARIN COMMUNITY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA M SKELLY CPC (BILLING MANAGER)
(415) 798-3135
Entity
Organization
Contact information
Practice address
1618 2ND ST, SAN RAFAEL, CA 94901-2707
(415) 448-1500
(415) 798-3104
Mailing address
PO BOX 5008, NOVATO, CA 94948-5008
(415) 448-1500
(415) 798-3104
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
03/15/2022
Last updated
10/03/2022
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