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1001 Potrero Ave San Francisco CA 94110-3518 | |
| (415) 759-4067 | |
| (415) 759-4649 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1001 Potrero Ave, San Francisco, California |
| Authorized Official Name and Position | Thomas John Istvan (DIRECTOR OF PFS) |
| Authorized Official Contact | 4157594064 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1001 Potrero Ave Building 20 Ward 24 San Francisco CA 94110-3518 Ph: (415) 759-4067 | 1001 Potrero Ave San Francisco CA 94110-3518 Ph: (415) 759-4067 |
| NPI Number | 1629011945 |
|---|---|
| Provider Enumeration Date | 06/14/2006 |
| Last Update Date | 02/16/2021 |
| Certification Date | 02/16/2021 |
| Medicare PECOS PAC ID | 1658280748 |
|---|---|
| Medicare Enrollment ID | O20070807000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629011945 | NPI | - | NPPES |
| 88121 | Other | CA | INPATIENT PSYCH DOYLE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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