Organization
PRIMA MEDICAL FOUNDATION
Active
Parent organization
PRIMA MEDICAL FOUNDATION
Other names
PRIMA MEDICAL GROUP
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMA MEDICAL FOUNDATION
Authorized official
DENNIS MONDRAGON (COO)
(415) 884-1840
Entity
Organization
Contact information
Practice address
652 PETALUMA AVE, SUITE H, SEBASTOPOL, CA 95472-4256
(707) 823-7616
(707) 823-2803
Mailing address
4 HAMILTON LNDG, SUITE 100, NOVATO, CA 94949-8256
(415) 884-1840
(415) 883-7127
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
06/05/2013
Last updated
06/05/2013
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