Prima Medical Foundation

NPI #1902244528 in Sebastopol, California

Provider Information

NPI Number: 1902244528
Entity Type: Organization
Organization Name: Prima Medical Foundation
Subpart: Yes (part of a larger organization)
Parent Organization: PRIMA MEDICAL FOUNDATION
Primary Specialty: General Practice
Enumeration Date: Jun 5, 2013
Last Updated: Jun 5, 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	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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