Healthcare Provider Details

I. General information

NPI: 1750149001
Provider Name (Legal Business Name): SAN FRANCISCO CBAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 STEINER ST
SAN FRANCISCO CA
94115-3526
US

IV. Provider business mailing address

17973 MEDLEY DR
ENCINO CA
91316-4377
US

V. Phone/Fax

Practice location:
  • Phone: 310-770-0366
  • Fax:
Mailing address:
  • Phone: 310-770-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA SUNDBERG
Title or Position: AUTHORIZED REP
Credential:
Phone: 619-414-4530