NPIMap

Organization Active NPI

Lifelong Medical Care

  • Clinic/Center
  • Richmond, CA
National Provider Identifier
1902177892
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIFELONG MEDICAL CARE
Practice address
2600 Macdonald Ave
Richmond, CA 94804-1826
Phone
(510) 981-4100
NPI assigned
Jan 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Authorized official

Name
Marty Lynch
Title
Ceo
Phone
(510) 981-4100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

2600 Macdonald Ave
Richmond, CA 94804-1826

Mailing address

PO Box 11247
Berkeley, CA 94712-2247
Phone (510) 981-4100

Other names 1

  • LifeLong Medical Care-Richmond Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 751100

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LIFELONG RICHMOND
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 14, 2014
Last certification
May 14, 2014
Ownership / control type
Non-profit – church related
Facility address
2600 Macdonald Avenue
Richmond, CA 94804

National Provider Directory

National Provider Directory
Tax ID family
Lifelong Medical44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1902177892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11247",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947122247",
            "telephone_number": "510-981-4100",
            "fax_number": "510-981-4193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MACDONALD AVE",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948041826",
            "telephone_number": "510-981-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG MEDICAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-24",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-981-4100"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeLong Medical Care-Richmond Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LifeLong Medical Care-Richmond Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, CA

Sources for this page

Verify at the official NPI Registry.