Healthcare Provider Details

I. General information

NPI: 1619297397
Provider Name (Legal Business Name): KATHY MEI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 THRIFT ST
SAN FRANCISCO CA
94112-2921
US

IV. Provider business mailing address

124 THRIFT ST
SAN FRANCISCO CA
94112-2921
US

V. Phone/Fax

Practice location:
  • Phone: 415-713-9787
  • Fax: 415-452-9373
Mailing address:
  • Phone: 415-713-9787
  • Fax: 415-452-9373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number18045
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number18045
License Number StateCA

VIII. Authorized Official

Name: MS. KATHY MEI
Title or Position: FNP
Credential: MSN
Phone: 415-713-9787