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155 5th St Ofmsc Suite 3f San Francisco CA 94103-2919 | |
| (415) 929-6617 | |
| (415) 794-3305 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 155 5th St, San Francisco, California |
| Authorized Official Name and Position | Ed Pegueros (ASSOC DEAN, BUDGET & FIN ADMIN, AO) |
| Authorized Official Contact | 4153517192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
155 5th St Ste 3f San Francisco CA 94103-2919 Ph: (415) 929-6617 | 155 5th St Ofmsc Suite 3f San Francisco CA 94103-2919 Ph: (415) 929-6617 |
| NPI Number | 1508294927 |
|---|---|
| Provider Enumeration Date | 10/22/2013 |
| Last Update Date | 12/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508294927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (California) | Primary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
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