NPIMap

Organization Active NPI

Prima Medical Foundation

  • Obstetrics & Gynecology Physician
  • Greenbrae, CA
National Provider Identifier
1609157734
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PRIMA MEDICAL FOUNDATION
Practice address
100 A Drakes Landing Rd
Suite 225
Greenbrae, CA 94904-3119
Phone
(415) 461-7800
NPI assigned
Sep 2, 2011
Organization subpart
Yes
Parent organization
PRIMA MEDICAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Joanna Rubel
Title
Sr. Director of Pratice Operations
Phone
(415) 842-5103

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X A65187 CA

Addresses

Primary practice location

100 A Drakes Landing Rd
Suite 225
Greenbrae, CA 94904-3119

Mailing address

4 Hamilton LNDG
Suite 100
Novato, CA 94949-8256
Phone (415) 884-1840

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ03538ZOtherCAMEDICARE PTAN

National Provider Directory

National Provider Directory
Tax ID family
Prima Medical Foundation Sebastopol19 organizations share this tax ID, including this one
Part of
Prima Medical Foundation Sebastopol

Other organizations with this tax ID 18

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

View all 18

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1609157734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 HAMILTON LNDG",
            "address_2": "SUITE 100",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949498256",
            "telephone_number": "415-884-1840",
            "fax_number": "415-884-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 A DRAKES LANDING RD",
            "address_2": "SUITE 225",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949043119",
            "telephone_number": "415-461-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMA MEDICAL FOUNDATION",
        "enumeration_date": "2011-09-02",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "RUBEL",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "SR. DIRECTOR OF PRATICE OPERATIONS",
        "authorized_official_telephone_number": "415-842-5103"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A65187",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ03538Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbrae, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.