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General NPI Number Information
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NPI Number | 1932256294
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Entity Type | Organization
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Legal Business Name | MARINER MEDICAL CENTER
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 1261 E HILLSDALE BLVD STE 1
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City | FOSTER CITY
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State | CA
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Zip | 94404-1236
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Country | US
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Telephone | 650-570-2299
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Fax | 650-570-5949
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Provider Business Mailing Address
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Address Line | 1241 E HILLSDALE BLVD 2ND FLOOR
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City | FOSTER CITY
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State | CA
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Zip | 94404-1241
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Country | US
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Telephone | 650-570-2299
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Fax | 650-570-5949
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KAREN SAUERMANN
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Credential |
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Telephone | 650-570-2299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A83248
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A80784
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G79688
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G48428
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License Number State | CA
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