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548 Market St # 47606 San Francisco CA 94104-5401 | |
| (708) 872-7108 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 548 Market St # 47606, San Francisco, California |
| Authorized Official Name and Position | Awss Zidan (PRESIDENT) |
| Authorized Official Contact | 4155345527 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2045 W Grand Ave Ste B Pmb 89496 Chicago IL 60612 Ph: (708) 630-1534 | 548 Market St # 47606 San Francisco CA 94104-5401 Ph: (708) 872-7108 |
| NPI Number | 1720703325 |
|---|---|
| Provider Enumeration Date | 10/05/2022 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/05/2024 |
| Medicare PECOS PAC ID | 6608246194 |
|---|---|
| Medicare Enrollment ID | O20221227001298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720703325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Katherine Rose Hulbert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225270903 PECOS PAC ID: 0244470102 Enrollment ID: I20130717000631 |
| Provider Name | Monica Lavian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730446774 PECOS PAC ID: 8628384526 Enrollment ID: I20170925002356 |
| Provider Name | Noreen Flanagan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508186594 PECOS PAC ID: 1850525635 Enrollment ID: I20240702002060 |
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