NPIMap

Organization Active NPI

Lifelong Medical Care

  • Family Medicine Physician
  • Rodeo, CA
National Provider Identifier
1003289463
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFELONG MEDICAL CARE
Practice address
25 California St
Rodeo, CA 94572-1310
Phone
(510) 981-4100
NPI assigned
Nov 6, 2015
Last updated
Jan 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFELONG MEDICAL CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Martin Lynch
Title
Chief Executive Officer
Phone
(510) 981-4123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

25 California St
Rodeo, CA 94572-1310

Mailing address

PO Box 11247
Berkeley, CA 94712-2247
Phone (510) 981-4122

Other names 1

  • LifeLong Medical Care Rodeo Health Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050713000704 CA Part B Supplier - Clinic/Group Practice 2062304538 Receives reassigned benefits from 260 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rodeo, CA; Richmond, CA; Oakland, CA; Berkeley, CA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lifelong Medical Center44 organizations share this tax ID, including this one
Part of
Lifelong Medical Center

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

1860 Alcatraz Ave
Berkeley, CA 94703
Phone (510) 280-6080

2031 6th St
Berkeley, CA 94710
Phone (510) 981-4200

1905 Novato Blvd
Novato, CA 94947
Phone (415) 897-6884

10700 MacArthur Blvd
Ste B
Oakland, CA 94605
Phone (510) 563-4300

2730 Adeline St
Oakland, CA 94607
Phone (510) 446-7100

386 14th St
Oakland, CA 94612
Phone (510) 210-5050

600 16th St
Oakland, CA 94612
Phone (510) 451-4270

806 San Pablo Ave
Pinole, CA 94564
Phone (510) 981-3255

1030 Nevin Ave
Richmond, CA 94801
Phone (510) 215-5001

2 California St
Rodeo, CA 94572
Phone (415) 364-3018

2023 Vale Rd
Ste 107
San Pablo, CA 94806
Phone (510) 215-9092

Practitioners & affiliated clinicians

Practitioners 270

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 270

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1003289463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11247",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947122247",
            "telephone_number": "510-981-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CALIFORNIA ST",
            "city": "RODEO",
            "state": "CA",
            "postal_code": "945721310",
            "telephone_number": "510-981-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG MEDICAL CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFELONG MEDICAL CARE",
        "enumeration_date": "2015-11-06",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "510-981-4123",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeLong Medical Care Rodeo Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rodeo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.