| Main Clinic | |
|
155 5th St Suite 23m San Francisco CA 94103-2919 | |
| (415) 929-6501 | |
| (415) 929-6654 |
| Full Name | Main Clinic |
|---|---|
| Speciality | Dentist |
| Location | 155 5th St, San Francisco, California |
| Authorized Official Name and Position | Ed Pegueros (ASST DEAN, BUDGET & FIN ADMIN) |
| Authorized Official Contact | 4153517192 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Clinic 155 5th St Suite 23m San Francisco CA 94103-2919 Ph: (415) 929-6501 | Main Clinic 155 5th St Suite 23m San Francisco CA 94103-2919 Ph: (415) 929-6501 |
| NPI Number | 1023145307 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 07/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023145307 | NPI | - | NPPES |
| G01001-01 | Other | CA | MEDI-CAL PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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