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General NPI Number Information
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NPI Number | 1356779359
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Entity Type | Organization
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Legal Business Name | MULDER & BAUMBACHER MDS INC.
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Dates
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Enumeration Date | 10/29/2013
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 300 TAMAL PLZ STE 150
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City | CORTE MADERA
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State | CA
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Zip | 94925-1160
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Country | US
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Telephone | 415-924-2195
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Fax | 415-924-3841
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Provider Business Mailing Address
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Address Line | 300 TAMAL PLZ STE 150
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City | CORTE MADERA
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State | CA
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Zip | 94925-1160
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Country | US
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Telephone | 415-924-2195
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Fax | 415-924-3841
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | CAROLINE MULDER
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Credential | MD
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Telephone | 415-924-3801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | G20951
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | G75410
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License Number State | CA
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