Healthcare Provider Details

I. General information

NPI: 1629370499
Provider Name (Legal Business Name): MARIN CANCER CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 S ELISEO DR SUITE 200
GREENBRAE CA
94904-2011
US

IV. Provider business mailing address

1350 S ELISEO DR SUITE 200
GREENBRAE CA
94904-2011
US

V. Phone/Fax

Practice location:
  • Phone: 415-925-5000
  • Fax:
Mailing address:
  • Phone: 415-925-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: HARVEY D BICHKOFF
Title or Position: CEO
Credential: MPH
Phone: 415-925-5010