Organization
MARIN CITY HEALTH AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD JAYVON (EXECUTIVE DIRECTOR)
(415) 339-8813
Entity
Organization
Contact information
Practice address
1601 2ND ST, SUITE 108, SAN RAFAEL, CA 94901-2712
(415) 339-8813
(415) 339-8814
Mailing address
630 DRAKE AVE, SAUSALITO, CA 94965-1107
(415) 339-8813
(415) 339-8814
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550000861
CA
Other
Enumeration date
04/08/2013
Last updated
03/04/2016
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