Sports Massage Marin

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

SPORTS MASSAGE MARIN

Practice address

645 Tamalpais Dr
Corte Madera, CA 94925-1613

Phone

(415) 310-0878

NPI assigned

Nov 15, 2016

Organization subpart

No

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

Authorized official

Name

Stefan Smith

Title

General Partner

Phone

(415) 310-0878

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479168000000",
    "number": "1588106942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 TAMALPAIS DR",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251613",
            "telephone_number": "415-310-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 TAMALPAIS DR",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251613",
            "telephone_number": "415-310-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MASSAGE MARIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "415-310-0878"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Corte Madera, CA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.