Provider Demographics
NPI:1659609964
Name:MARIN HEALTHCARE DISTRICT
Entity Type:Organization
Organization Name:MARIN HEALTHCARE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-464-2095
Mailing Address - Street 1:100 B DRAKES LANDING ROAD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-3121
Mailing Address - Country:US
Mailing Address - Phone:415-464-2090
Mailing Address - Fax:415-464-2094
Practice Address - Street 1:100 B DRAKES LANDING ROAD,
Practice Address - Street 2:STE. 250
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-3121
Practice Address - Country:US
Practice Address - Phone:415-464-2090
Practice Address - Fax:415-464-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center