| Gary Birnbaum Md Prof Corp | |
|
97 Vista Del Sol Mill Valley CA 94941-4920 | |
| (415) 350-0639 | |
| (415) 366-2882 |
| Full Name | Gary Birnbaum Md Prof Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 97 Vista Del Sol, Mill Valley, California |
| Authorized Official Name and Position | David G Harnden (ADMINISTRATIVE MANAGER) |
| Authorized Official Contact | 4156482021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary Birnbaum Md Prof Corp 97 Vista Del Sol Mill Valley CA 94941-4920 Ph: (415) 350-0639 | Gary Birnbaum Md Prof Corp 97 Vista Del Sol Mill Valley CA 94941-4920 Ph: (415) 350-0639 |
| NPI Number | 1255807152 |
|---|---|
| Provider Enumeration Date | 10/17/2018 |
| Last Update Date | 10/17/2018 |
| Medicare PECOS PAC ID | 9133471576 |
|---|---|
| Medicare Enrollment ID | O20181011002631 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255807152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gary B Birnbaum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972685972 PECOS PAC ID: 6507928926 Enrollment ID: I20081218000762 |
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