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General NPI Number Information
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NPI Number | 1639838576
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Entity Type | Organization
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Legal Business Name | NORTH BAY PRIVATE MEDICINE, INC.
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 655 REDWOOD HWY FRONTAGE RD STE 160
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City | MILL VALLEY
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State | CA
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Zip | 94941-3068
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Country | US
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Telephone | 415-500-6220
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Fax | 415-500-6240
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Provider Business Mailing Address
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Address Line | 655 REDWOOD HWY FRONTAGE RD STE 160
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City | MILL VALLEY
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State | CA
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Zip | 94941-3068
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Country | US
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Telephone | 415-500-6220
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Fax | 415-500-6240
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | REBEKAH A LEWIS
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Credential | MD
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Telephone | 415-500-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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