Organization Name: | MARIN MEDICAL LABORATORIES |
NPI Number: | 1962504977 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL WILLIAM WASSERSTEIN (MANAGING PARTNER) |
Mailing Address: | 1300 South Eliseo Drive Suite 102 Greenbrae |
State: | CA US |
Postal Code: | 94904 |
Phone Number: | 4159256967 |
Fax Number: | 4154614913 |
NPI Enumeration Date: | 09/01/2006 |
NPI Last Update Date: | 10/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | CLIA |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |