Organization
PRIMA MEDICAL GROUP-TERRA LINDA
Active
Parent organization
PRIMA MEDICAL FOUNDATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMA MEDICAL FOUNDATION
Authorized official
MR. JOEL A CRISTE (CEO)
(415) 884-1840
Entity
Organization
Contact information
Practice address
4000 CIVIC CENTER DRIVE, SUITE 200B, SAN RAFAEL, CA 94903
(415) 492-3333
(415) 492-3425
Mailing address
4 HAMILTON LANDING, SUITE 100, NOVATO, CA 94949
(415) 884-1840
(415) 884-3510
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G73451
CA
261QM1300X
Multi-Specialty Clinic/Center
G55637
CA
Other
Enumeration date
10/03/2011
Last updated
08/14/2012
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