Organization
LIFELONG MEDICAL CARE
Active
Organization
LIFELONG MEDICAL CARE
Active
Other names
OVER SIXTY HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTY LYNCH N/A (CEO)
(510) 981-4100
Entity
Organization
Contact information
Practice address
3260 SACRAMENTO ST, BERKELEY, CA 94702-2739
(510) 428-4500
Mailing address
PO BOX 11247, BERKELEY, CA 94712-2247
(510) 981-4100
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
140000191
CA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
140000191
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70859F
—
CA
Enumeration date
06/21/2005
Last updated
10/23/2009
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