Healthcare Provider Details

I. General information

NPI: 1225516560
Provider Name (Legal Business Name): ONEDERFUL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

834 JONES ST
SAN FRANCISCO CA
94109-6354
US

IV. Provider business mailing address

834 JONES ST
SAN FRANCISCO CA
94109-6354
US

V. Phone/Fax

Practice location:
  • Phone: 626-354-7097
  • Fax:
Mailing address:
  • Phone: 626-354-7097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name: ALEX YEE
Title or Position: CTO
Credential:
Phone: 626-780-7981