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General NPI Number Information
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NPI Number | 1023041753
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Entity Type | Organization
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Legal Business Name | MARIN HOSPITALIST MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 08/19/2020
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Provider Practice Location Address
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Address Line | 250 BON AIR RD 3RD FLOOR
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City | GREENBRAE
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State | CA
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Zip | 94904-1702
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Country | US
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Telephone | 415-925-7545
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Fax | 415-925-7008
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Provider Business Mailing Address
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Address Line | 336 BON AIR CENTER #427
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City | GREENBRAE
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State | CA
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Zip | 94904
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Country | US
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Telephone | 415-925-7545
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Fax | 415-925-7008
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Authorized Official
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Title or Position | CEO
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Name | MR. DOUGLAS COHEN
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Credential | MD
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Telephone | 415-518-8115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G73589
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License Number State | CA
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