Healthcare Provider Details

I. General information

NPI: 1871158675
Provider Name (Legal Business Name): ROBERT H. LANGSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 05/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3838 CALIFORNIA ST RM 815
SAN FRANCISCO CA
94118-1510
US

IV. Provider business mailing address

3838 CALIFORNIA ST RM 815
SAN FRANCISCO CA
94118-1510
US

V. Phone/Fax

Practice location:
  • Phone: 415-401-5899
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT H LANGSTON
Title or Position: PRESIDENT
Credential:
Phone: 415-401-5899