Healthcare Provider Details

I. General information

NPI: 1982861746
Provider Name (Legal Business Name): SAMANTHA ANNE GOLDSTEIN KAMRAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 BON AIR RD MARIN COMMUNITY CLINICS
GREENBRAE CA
94904-1702
US

IV. Provider business mailing address

250 BON AIR RD MARIN COMMUNITY CLINICS
GREENBRAE CA
94904-1702
US

V. Phone/Fax

Practice location:
  • Phone: 415-448-1500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA101610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: