| Concussion And Migraine Clinic | |
|
815 Hyde St San Francisco CA 94109-5996 | |
| (415) 673-5700 | |
| (415) 292-7140 |
| Full Name | Concussion And Migraine Clinic |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 815 Hyde St, San Francisco, California |
| Authorized Official Name and Position | Joanne Azulay (OWNER) |
| Authorized Official Contact | 4156735700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Concussion And Migraine Clinic 815 Hyde St San Francisco CA 94109-5996 Ph: (415) 673-5700 | Concussion And Migraine Clinic 815 Hyde St San Francisco CA 94109-5996 Ph: (415) 673-5700 |
| NPI Number | 1396418190 |
|---|---|
| Provider Enumeration Date | 07/28/2021 |
| Last Update Date | 01/25/2022 |
| Certification Date | 01/25/2022 |
| Medicare PECOS PAC ID | 7517365117 |
|---|---|
| Medicare Enrollment ID | O20220113001693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396418190 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kenny A Karyadi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1699279679 PECOS PAC ID: 0840552881 Enrollment ID: I20180402002256 |
| Provider Name | Joanne Azulay |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730258740 PECOS PAC ID: 8628006038 Enrollment ID: I20220127002861 |
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