Prima Medical Foundation Sebastopol
NPI #1154590958 in Sebastopol, California
Provider Information
- NPI Number
- 1154590958
- Entity Type
- Organization
- Organization Name
- Prima Medical Foundation Sebastopol
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- PRIMA MEDICAL FOUNDATION
- Primary Specialty
- Clinic/Center - Multi-Specialty
- Enumeration Date
- Feb 26, 2008
- Last Updated
- Apr 24, 2013
Practice Location
- Address
- 652 PETALUMA AVE
- Address 2
- SUITE H
- City
- Sebastopol
- State
- California
- ZIP Code
- 95472-4256
- Phone
- (707) 823-7616
Authorized Official
- Name
- DENNIS MONDRAGON
- Title
- COO
- Phone
- (415) 884-1840
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
| Clinic/Center - Multi-Specialty — Multi-Specialty |
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