Healthcare Provider Details

I. General information

NPI: 1700269164
Provider Name (Legal Business Name): COTTRELL ARMISTAD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1663 MISSION ST STE 250
SAN FRANCISCO CA
94103-2488
US

IV. Provider business mailing address

1663 MISSION ST STE 250
SAN FRANCISCO CA
94103-2488
US

V. Phone/Fax

Practice location:
  • Phone: 415-386-6600
  • Fax: 415-751-3226
Mailing address:
  • Phone: 415-386-6600
  • Fax: 415-751-3226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: