MEDICARE: LIFELONG MEDICAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center		CA

General Provider Information

NPI Number	:	1528194339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFELONG MEDICAL CARE

Provider Business Mailing Address
First Line	:	2344 6TH ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94710-2412
Country	:	US
Telephone Number	:	510-981-4123
Fax Number	:

Provider Business Practice Location Address
First Line	:	10700 MACARTHUR BLVD
Second Line	:	SUITE 14A
City	:	OAKLAND
State	:	CA
Zip	:	94605-5298
Country	:	US
Telephone Number	:	510-563-4390
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARTY LYNCH
Credential	:
Telephone Number	:	510-981-4123

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	08/22/2020

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Directions to “LIFELONG MEDICAL CARE ” Practice Location

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