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General NPI Number Information
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NPI Number | 1699844050
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Entity Type | Organization
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Legal Business Name | MARINDALE MEDICAL THERAPY UNIT
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 05/27/2023
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Provider Practice Location Address
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Address Line | 850 DEL GANADO RD
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City | SAN RAFAEL
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State | CA
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Zip | 94903-2310
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Country | US
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Telephone | 415-479-2203
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Fax | 415-446-4476
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Provider Business Mailing Address
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Address Line | 3240 KERNER BLVD
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City | SAN RAFAEL
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State | CA
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Zip | 94901
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Country | US
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Telephone | 415-473-6893
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Fax | 415-473-6396
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Authorized Official
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Title or Position | CHIEF THERAPIST
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Name | NANCY ADUNA
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Credential | P.T.
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Telephone | 415-473-6893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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