Inner Illuminations, Pc | |
369 Pine Street Ste 629 San Francisco CA 94104 | |
(415) 819-5300 | |
(415) 477-4035 |
Full Name | Inner Illuminations, Pc |
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Speciality | Clinic/Center |
Location | 369 Pine Street Ste 629, San Francisco, California |
Authorized Official Name and Position | R Robert Eskuchen (OWNER) |
Authorized Official Contact | 4158195300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Inner Illuminations, Pc 369 Pine Street Ste 629 San Francisco CA 94104 Ph: (415) 819-5300 | Inner Illuminations, Pc 369 Pine Street Ste 629 San Francisco CA 94104 Ph: (415) 819-5300 |
NPI Number | 1508199357 |
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Provider Enumeration Date | 09/11/2009 |
Last Update Date | 02/10/2020 |
Certification Date | 02/10/2020 |
Medicare PECOS PAC ID | 9335575141 |
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Medicare Enrollment ID | O20200213002229 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508199357 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 060370 (Georgia) | Primary |
Provider Name | Raymond Robert Eskuchen |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1548448624 PECOS PAC ID: 1254499957 Enrollment ID: I20200213002331 |
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