Lifelong Medical Care
Organization Active NPI Family Medicine Physician · Rodeo, CA
NPI 1003289463 · NPPES record last updated Jan 16, 2024
Key facts
- NPI
- 1003289463
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 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
- Organization subpart
- Yes
- Parent organization (as reported)
- LIFELONG MEDICAL CARE
Authorized official
- Name
- Mr. Martin Lynch
- Title
- Chief Executive Officer
- Phone
- (510) 981-4123
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 43
Practitioners 270
-
Gabriel R Aguilar, PA-C
-
Adebowale Arshad, NURSE PRACTITIONER
-
Nicole Atme-Bahrani, FNP
-
Mariam Attawia, NP
-
Arthur E. Bakal, MD
-
Erica Bass, MD
-
Jessica D Bigler Uhl, LCSW
-
Emily K Birenbaum, M.D.
-
Cris Bissonnette, PMHNP, FNP
-
Nicole Lynn Bores, M.D.
-
Sarah Romanow Briand, CNM
-
Ashli Butler, FNP
-
Alea Catherine Campos, MSN, FNP, RN
-
Caroline Cangelosi, LCSW
-
Kimberly H Cardoso, CNM, NP, MS
-
Karen Carothers, MD
-
Desmond Earl Carson, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Lifelong Medical
- Part of
- Lifelong Medical
Locations
1860 Alcatraz Ave
Berkeley, CA 94703
Phone (510) 280-6080
2001 Dwight Way
Rm 1363
Berkeley, CA 94704
Phone (510) 204-4637
1905 Novato Blvd
Novato, CA 94947
Phone (415) 897-6884
600 16th St
Oakland, CA 94612
Phone (510) 451-4270
10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300
10700 MacArthur Blvd
Ste B
Oakland, CA 94605
Phone (510) 563-4300
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
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
- LifeLong Medical Care Rodeo Health Center
Other providers in Rodeo, CA
- Jergensen Dental PC
- John Swett Unified School District
- Amanpreet Kaur
- Karen Kopiko
- Olivia Lay
- Liznaval,Inc
- Laura McCunniff Reid
- Margaret McKee
- Jesus Eduardo Medina-Sanchez
- Diego Ernesto Mendoza Perez Sr.
All providers in Rodeo, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.