Provider Demographics
NPI:1578198099
Name:KATHRYN NAJAFI TAGOL MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:KATHRYN NAJAFI TAGOL MD A PROFESSIONAL CORPORATION
Other - Org Name:EYE INSTITUTE OF MARIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:NAJAFI-TAGOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-444-0300
Mailing Address - Street 1:4000 CIVIC CENTER DR STE 200A
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-5233
Mailing Address - Country:US
Mailing Address - Phone:415-444-0300
Mailing Address - Fax:
Practice Address - Street 1:4000 CIVIC CENTER DR STE 200A
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-5233
Practice Address - Country:US
Practice Address - Phone:415-444-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty