| Marin Gastroenterology | |
|
200 Tamal Plz Ste 200 Corte Madera CA 94925-1196 | |
| (415) 925-6900 | |
| (415) 925-6900 |
| Full Name | Marin Gastroenterology |
|---|---|
| Speciality | Pathology |
| Location | 200 Tamal Plz Ste 200, Corte Madera, California |
| Authorized Official Name and Position | Timothy Sowerby (MANAGING PARTNER) |
| Authorized Official Contact | 4159256900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marin Gastroenterology 200 Tamal Plz Ste 200 Corte Madera CA 94925-1196 Ph: (415) 925-6900 | Marin Gastroenterology 200 Tamal Plz Ste 200 Corte Madera CA 94925-1196 Ph: (415) 925-6900 |
| NPI Number | 1730125758 |
|---|---|
| Provider Enumeration Date | 06/20/2006 |
| Last Update Date | 03/14/2022 |
| Medicare PECOS PAC ID | 9830131580 |
|---|---|
| Medicare Enrollment ID | O20050524000401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730125758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Secondary |
| 207ZP0105X | Pathology - Clinical Pathology/laboratory Medicine | (* (Not Available)) | Primary |
| Provider Name | Kedar Che Prasad |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1841308558 PECOS PAC ID: 0840191375 Enrollment ID: I20040117000176 |
| Provider Name | Imok Cha |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1619085263 PECOS PAC ID: 6709865470 Enrollment ID: I20040715001402 |
| Provider Name | Natalie C Lee |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447371505 PECOS PAC ID: 3375512734 Enrollment ID: I20041001000359 |
| Provider Name | Timothy M Sowerby |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063475952 PECOS PAC ID: 4082658323 Enrollment ID: I20050616000927 |
| Provider Name | Vikram Malladi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902814015 PECOS PAC ID: 5294833026 Enrollment ID: I20080919000443 |
| Provider Name | Frederick J Kretzschmar |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1245348861 PECOS PAC ID: 5294828521 Enrollment ID: I20081211000835 |
| Provider Name | John Bettinger |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225037500 PECOS PAC ID: 7012013881 Enrollment ID: I20090713000064 |
| Provider Name | Ripple Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205003167 PECOS PAC ID: 9638202138 Enrollment ID: I20100804000928 |
| Provider Name | Amy J Holm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407192438 PECOS PAC ID: 4981849262 Enrollment ID: I20130315000176 |
| Provider Name | Wendy Z Davis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336293653 PECOS PAC ID: 1254346067 Enrollment ID: I20131031000113 |
| Provider Name | Christopher J Kim |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356607121 PECOS PAC ID: 8628369527 Enrollment ID: I20160623002480 |
| Provider Name | Christopher M Hogan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376867010 PECOS PAC ID: 6901114826 Enrollment ID: I20160726003155 |
| Provider Name | Natalya Hakim |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1144682444 PECOS PAC ID: 0446526115 Enrollment ID: I20210215001670 |
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