Organization
LIFELONG MEDICAL CARE
Active
Other names
WEST BERKELEY FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTY LYNCH N/A (CEO)
(510) 981-4100
Entity
Organization
Contact information
Practice address
2031 6TH ST, BERKELEY, CA 94710-2006
(510) 981-4200
Mailing address
PO BOX 11247, BERKELEY, CA 94712-2247
(510) 981-4100
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
020000503
CA
207QA0505X
Adult Medicine Physician
020000503
CA
207V00000X
Obstetrics & Gynecology Physician
020000503
CA
208000000X
Pediatrics Physician
020000503
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70635F
—
CA
01
—
HAP70635F
FAMILY PACT
CA
Enumeration date
06/21/2005
Last updated
04/04/2022
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