Organization
MARIN INDIVIDUAL PRACTICE ASSOCIATION
Active
Organization
MARIN INDIVIDUAL PRACTICE ASSOCIATION
Active
Parent organization
MARIN INDIVIDUAL PRACTICE ASSOCIATION
Other names
DBA: Core Physical Therapy, DBA: Meritage Medical Network
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARIN INDIVIDUAL PRACTICE ASSOCIATION
Authorized official
WOJTEK NOWAK (CHIEF EXECUTIVE OFFICER)
(415) 884-1818
Entity
Organization
Contact information
Practice address
1401 LOS GAMOS DRIVE, SUITE 140, SAN RAFAEL, CA 94903
(415) 479-7100
(415) 479-7137
Mailing address
1401 LOS GAMOS DRIVE, SUITE 140, SAN RAFAEL, CA 94903
(415) 479-7100
(415) 479-7137
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
041525
CA
Other
Enumeration date
07/12/2006
Last updated
03/26/2018
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