Healthcare Provider Details
I. General information
NPI: 1386528891
Provider Name (Legal Business Name): PACIFIC VISION FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
711 VAN NESS AVE STE 430
SAN FRANCISCO CA
94102-3284
US
IV. Provider business mailing address
711 VAN NESS AVE STE 260
SAN FRANCISCO CA
94102-3272
US
V. Phone/Fax
- Phone: 415-997-6521
- Fax: 415-430-9748
- Phone:
- Fax: 415-430-9748
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
CHANG
Title or Position: CEO
Credential:
Phone: 415-393-1225