| Primary Care At Sfo Medical Clinic | |
|
San Francisco International Airport International Terminal, Level 3, A Side, Hwy 101 San Francisco CA 94128-3128 | |
| (415) 688-1000 | |
| Not Available |
| Full Name | Primary Care At Sfo Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | San Francisco International Airport, San Francisco, California |
| Authorized Official Name and Position | Fernando S. Moreno (CFO/DIRECTOR) |
| Authorized Official Contact | 4155146118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care At Sfo Medical Clinic Po Box 885904 Los Angeles CA 90088-5904 Ph: (415) 353-4739 | Primary Care At Sfo Medical Clinic San Francisco International Airport International Terminal, Level 3, A Side, Hwy 101 San Francisco CA 94128-3128 Ph: (415) 688-1000 |
| NPI Number | 1023151057 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 08/26/2024 |
| Medicare PECOS PAC ID | 2062320559 |
|---|---|
| Medicare Enrollment ID | O20080624000414 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023151057 | NPI | - | NPPES |
| ZZZ04911Z | Other | CA | BLUE SHIELD |
| 912152210 | Other | IRS | |
| 193623600 | Other | DEPT. OF LABOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 220000071 (California) | Primary |
| Provider Name | Meshell D Johnson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1093755761 PECOS PAC ID: 0042209082 Enrollment ID: I20040506001111 |
| Provider Name | Arnold I Traynis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962456749 PECOS PAC ID: 9335138387 Enrollment ID: I20040506001169 |
| Provider Name | Meshell D Johnson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093755761 PECOS PAC ID: 0042209082 Enrollment ID: I20100929000436 |
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