| Lifelong Medical Care | |
|
2001 Dwight Way Rm 1363 Berkeley CA 94704-2608 | |
| (510) 204-4666 | |
| Not Available |
| Full Name | Lifelong Medical Care |
|---|---|
| Speciality | Family Medicine |
| Location | 2001 Dwight Way, Berkeley, California |
| Authorized Official Name and Position | Marty Lynch (CEO) |
| Authorized Official Contact | 5109814100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifelong Medical Care Po Box 11247 Berkeley CA 94712-2247 Ph: (510) 981-4100 | Lifelong Medical Care 2001 Dwight Way Rm 1363 Berkeley CA 94704-2608 Ph: (510) 204-4666 |
| NPI Number | 1518963693 |
|---|---|
| Provider Enumeration Date | 06/23/2005 |
| Last Update Date | 10/23/2009 |
| Medicare PECOS PAC ID | 2062304538 |
|---|---|
| Medicare Enrollment ID | O20091007000222 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518963693 | NPI | - | NPPES |
| HAP70474G | Other | CA | FAMILY PACT |
| FHC70474G | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 140000372 (California) | Primary |
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