Healthcare Provider Details
I. General information
NPI: 1790578466
Provider Name (Legal Business Name): DOCTRONIC PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/27/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2948 16TH ST STE 200-6
SAN FRANCISCO CA
94103-3613
US
IV. Provider business mailing address
6742 FOREST HILL BLVD # 283
GREENACRES FL
33413-3321
US
V. Phone/Fax
- Phone: 415-340-2274
- Fax:
- Phone: 415-340-2274
- Fax: 415-621-9221
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICOLE
GUETHLER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 415-340-2274