Marin Personalized Medicine, Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

MARIN PERSONALIZED MEDICINE, INC.

Practice address

895 Sir Francis Drake Blvd
San Anselmo, CA 94960-1916

Phone

(415) 925-3617

NPI assigned

Jul 11, 2013

Organization subpart

No

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

Authorized official

Name

David L Ogden, MDNPI 1003887324

Title

Owner/Provider

Phone

(415) 925-3596

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David L Ogden, M.D.

  • Internal Medicine Physician
  • San Anselmo, CA
  • NPI 1003887324
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634169600000",
    "number": "1780025361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 SIR FRANCIS DRAKE BLVD",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601916",
            "telephone_number": "415-925-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 SIR FRANCIS DRAKE BLVD",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601916",
            "telephone_number": "415-925-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN PERSONALIZED MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "OGDEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "415-925-3596",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Ann Maccabe, PHARMACY TECHNICIAN
• Rachel Elizabeth Manfredi
• Mary Manning, RDN
• Marin Community Clinic
• Marin Imaging
• Christina Marini, AMFT
• David Steven Mars, LMFT
• Antoni Efthemios Mavrantonis, R.PH.
• Jodi McClain, OTR/L
• Michael McCulloch, LAC

• Medical Specialty Clinic/Center in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.