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1735 Mission St Fl 1 San Francisco CA 94103-2417 | |
| (415) 565-7667 | |
| (415) 252-7512 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1735 Mission St Fl 1, San Francisco, California |
| Authorized Official Name and Position | Vitka Eisen (CHIEF EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4157623700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1563 Mission St, 4th Floor San Francisco CA 94103-2543 Ph: (415) 762-3712 | 1735 Mission St Fl 1 San Francisco CA 94103-2417 Ph: (415) 565-7667 |
| NPI Number | 1568556363 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 11/15/2017 |
| Medicare PECOS PAC ID | 3678674025 |
|---|---|
| Medicare Enrollment ID | O20150504000935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568556363 | NPI | - | NPPES |
| 80240F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 220000121 (California) | Primary |
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