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General NPI Number Information
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NPI Number | 1144188327
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Entity Type | Organization
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Legal Business Name | LIFELONG MEDICAL CARE
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 100 SAN PABLO TOWNE CTR
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City | SAN PABLO
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State | CA
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Zip | 94806-3926
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Country | US
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Telephone | 510-981-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 2850 7TH ST # 200
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City | BERKELEY
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State | CA
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Zip | 94710-2703
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Country | US
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Telephone | 916-749-6192
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Fax | 916-749-6192
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Authorized Official
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Title or Position | CHIEF OF MEDICAL OPERTIONS
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Name | KIMBERLY ANN CECI
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Credential | MD
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Telephone | 510-981-3203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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