Healthcare Provider Details

I. General information

NPI: 1720509631
Provider Name (Legal Business Name): SS INTEGRATIVE MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 LOMBARD ST STE 2
SAN FRANCISCO CA
94111-1169
US

IV. Provider business mailing address

150 LOMBARD ST STE 2
SAN FRANCISCO CA
94111-1169
US

V. Phone/Fax

Practice location:
  • Phone: 415-421-1115
  • Fax: 415-421-1116
Mailing address:
  • Phone: 415-421-1115
  • Fax: 415-421-1116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32975
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number16580
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. SUPREET SHAH
Title or Position: OWNER
Credential:
Phone: 847-730-9035