Healthcare Provider Details

I. General information

NPI: 1972325058
Provider Name (Legal Business Name): WW CLINIC MIDWEST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 CALIFORNIA ST, STE 1400
SAN FRANCISCO CA
94104
US

IV. Provider business mailing address

425 CALIFORNIA ST STE 1400
SAN FRANCISCO CA
94104-2116
US

V. Phone/Fax

Practice location:
  • Phone: 212-589-2700
  • Fax: 650-360-0447
Mailing address:
  • Phone: 212-589-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN HINDS
Title or Position: PRESIDENT
Credential: MD
Phone: 212-589-2700