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1015 Rhode Island St San Francisco CA 94107-3214 | |
| (617) 319-4012 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Pediatrics |
| Location | 1015 Rhode Island St, San Francisco, California |
| Authorized Official Name and Position | Luis Alesandro Larrazabal Martinez (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 4154098493 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1015 Rhode Island St San Francisco CA 94107-3214 Ph: () - | 1015 Rhode Island St San Francisco CA 94107-3214 Ph: (617) 319-4012 |
| NPI Number | 1649910589 |
|---|---|
| Provider Enumeration Date | 03/30/2022 |
| Last Update Date | 11/20/2024 |
| Certification Date | 11/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649910589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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