Provider Demographics
NPI:1992164628
Name:MARIN FOOT AND ANKLE
Entity type:Organization
Organization Name:MARIN FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:ROBISON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:415-388-2777
Mailing Address - Street 1:7 N KNOLL RD STE 3
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1665
Mailing Address - Country:US
Mailing Address - Phone:415-388-2777
Mailing Address - Fax:415-388-2778
Practice Address - Street 1:7 N KNOLL RD STE 3
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-1665
Practice Address - Country:US
Practice Address - Phone:415-388-2777
Practice Address - Fax:415-388-2778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty