NPIMap

Organization Active NPI

Marin General Hospital

  • General Acute Care Hospital
  • Greenbrae, CA
National Provider Identifier
1396725677
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
110000361 Issued in CA
Legal business name
MARIN GENERAL HOSPITAL
Practice address
250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone
(415) 925-7100
Fax
(415) 925-7933
NPI assigned
Jan 20, 2006
Last updated
Aug 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Authorized official

Name
Mr. Lee Domanico
Title
Chief Exec. Officer
Phone
(415) 925-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 110000361 CA Primary

Addresses

Primary practice location

250 Bon Air Rd
Greenbrae, CA 94904-1702

Mailing address

PO Box 8010
San Rafael, CA 94912-8010
Phone (415) 925-7100

Other identifiers 1

IdentifierTypeStateIssuer
HSM003606MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080108000816 CA Part A Provider - Hospital 7618057274 Practice locations: Greenbrae, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396725677. Details of each certification follow.

Hospital certification: CCN 050360

Legal name
MARIN GENERAL HOSPITAL
Doing business as
MARINHEALTH MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Oct 24, 2025
Beds
325 (235 certified)
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Incorporated
May 8, 1981 in CA
Enrollment address
250 Bon Air Rd
Greenbrae, CA 94904-1702
Main/Primary Hospital Location
Hospital subgroups
Acute care, Other

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Marinhealth Medical CenterCCN 050360 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Marin General Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

2450 Ashby Ave
Rm 3040
Berkeley, CA 94705
Phone (510) 204-3977

1720 Marco Polo Way
Ste A
Burlingame, CA 94010
Phone (650) 268-5260

1300 S Eliseo Dr
Ste 204
Greenbrae, CA 94904

1341 S Eliseo Dr
Greenbrae, CA 94904
Phone (415) 464-8169

900 S Eliseo Dr
Ste 102
Greenbrae, CA 94904
Phone (415) 461-8200

1030 Sir Francis Drake Blvd
Ste 130
Kentfield, CA 94904
Phone (415) 295-7249

1125 Sir Francis Drake Blvd
#1
Kentfield, CA 94904

1125 Sir Francis Drk Blvd
Kentfield, CA 94904
Phone (415) 456-9680

5 Bon Air Rd
Ste 117
Larkspur, CA 94939
Phone (415) 924-4870

10 Thomas Dr
Mill Valley, CA 94941
Phone (415) 380-8448

530 W Dunne Ave
Morgan Hill, CA 95037
Phone (408) 779-3633

165 Rowland Way
Ste 312
Novato, CA 94945
Phone (415) 897-2626

1700 San Pablo Ave
Ste E
Pinole, CA 94564
Phone (510) 724-1530

1825 4th St
#6A
San Francisco, CA 94143

3700 24th St
San Francisco, CA 94114
Phone (415) 641-1019

505 Parnassus Ave
Rm M786
San Francisco, CA 94143

File No 72429
San Francisco, CA 94160

711 D St
Ste 113
San Rafael, CA 94901
Phone (415) 454-4100

2330 Marinship Way
Sausalito, CA 94965

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrea Schultz Individual Corporate Director Apr 1, 2015
Joshua S Adler Individual Corporate Director Jun 1, 2018
David G Klein Individual Corporate OfficerCeo Sep 1, 2020
Operational/Managerial ControlCeo Sep 1, 2020
Adam W Nevitt Individual Corporate Director Jan 1, 2022
Michael K Kwok Individual Corporate Director Jan 1, 2019
Eric Brettner Individual Corporate Officer Sep 25, 2019
Marin Healthcare District Organization, Greenbrae, CA Non-profit Operational/Managerial Control Jun 30, 2010 100%
Joseph W Abrams Individual Corporate Director Jan 1, 2019
Joseph C Euphrat Individual Corporate Director Mar 1, 2017
Waldemar D Vasquez Individual Corporate Director Jan 1, 2023
Martin D Arrick Individual Corporate Director Feb 1, 2022
Denise Lucy Individual Corporate Director Dec 1, 2017
Mary H Mullin Individual Corporate Director Feb 1, 2022

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 297

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 297

Affiliated clinicians 902

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 902

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407369600000",
    "number": "1396725677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8010",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949128010",
            "telephone_number": "415-925-7100",
            "fax_number": "415-925-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BON AIR RD",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041702",
            "telephone_number": "415-925-7100",
            "fax_number": "415-925-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2014-08-07",
        "status": "A",
        "authorized_official_last_name": "DOMANICO",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "CHIEF EXEC. OFFICER",
        "authorized_official_telephone_number": "415-925-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "CA",
            "license": "110000361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSM003606",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

Verify at the official NPI Registry.