Healthcare Provider Details

I. General information

NPI: 1366909277
Provider Name (Legal Business Name): DISCOVER HEALTH MEDICA GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 COLUMBUS AVE
SAN FRANCISCO CA
94133
US

IV. Provider business mailing address

990 COLUMBUS AVE
SAN FRANCISCO CA
94133
US

V. Phone/Fax

Practice location:
  • Phone: 415-732-7029
  • Fax: 415-732-7030
Mailing address:
  • Phone: 415-732-7029
  • Fax: 415-732-7030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ODED HERBSMAN
Title or Position: OWNER CEO/PEDIATRICIAN
Credential: M.D.
Phone: 415-732-7029