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142 Alhambra St San Francisco CA 94123-2004 | |
| (415) 614-2612 | |
| (415) 614-2612 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 142 Alhambra St, San Francisco, California |
| Authorized Official Name and Position | Nader Nadershahi (DEAN) |
| Authorized Official Contact | 4159296400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
142 Alhambra St San Francisco CA 94123-2004 Ph: (415) 614-2612 | 142 Alhambra St San Francisco CA 94123-2004 Ph: (415) 614-2612 |
| NPI Number | 1194186999 |
|---|---|
| Provider Enumeration Date | 03/08/2016 |
| Last Update Date | 03/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194186999 | NPI | - | NPPES |
| 15309 | Other | CA | STATE LICENSE NUMBER |
| 15309 | Other | CA | CALIFORNIA DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 15309 (California) | Primary |
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