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400 Parnassus Ave Mcb 300 San Francisco CA 94143-2202 | |
| (415) 353-2273 | |
| (415) 353-2898 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 400 Parnassus Ave, San Francisco, California |
| Authorized Official Name and Position | Jed Shivers (COO) |
| Authorized Official Contact | 4154764003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1635 Divisadero St Suite 625, Box 1821 San Francisco CA 94143-0001 Ph: (415) 476-4029 | 400 Parnassus Ave Mcb 300 San Francisco CA 94143-2202 Ph: (415) 353-2273 |
| NPI Number | 1518030386 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518030386 | NPI | - | NPPES |
| GR008429D | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (California) | Primary |
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