Healthcare Provider Details

I. General information

NPI: 1164458402
Provider Name (Legal Business Name): CHINESE HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 PARIS ST
SAN FRANCISCO CA
94112-3857
US

IV. Provider business mailing address

888 PARIS ST
SAN FRANCISCO CA
94112-3857
US

V. Phone/Fax

Practice location:
  • Phone: 415-677-2488
  • Fax: 415-217-4199
Mailing address:
  • Phone: 415-677-2488
  • Fax: 415-217-4199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number550000121
License Number StateCA

VIII. Authorized Official

Name: MR. THOMAS BOLGER
Title or Position: CFO
Credential:
Phone: 415-677-2496