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1794 San Jose Ave San Francisco CA 94112-1955 | |
| (415) 586-3155 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1794 San Jose Ave, San Francisco, California |
| Authorized Official Name and Position | Phyllis Chen (OWNER) |
| Authorized Official Contact | 4155863155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1794 San Jose Ave San Francisco CA 94112-1955 Ph: (415) 586-3155 | 1794 San Jose Ave San Francisco CA 94112-1955 Ph: (415) 586-3155 |
| NPI Number | 1083771422 |
|---|---|
| Provider Enumeration Date | 01/03/2007 |
| Last Update Date | 06/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083771422 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 46570 (California) | Primary |
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