Healthcare Provider Details

I. General information

NPI: 1578777850
Provider Name (Legal Business Name): GWART,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CORNWALL ST # 401
SAN FRANCISCO CA
94118-1429
US

IV. Provider business mailing address

5 CORNWALL ST # 401
SAN FRANCISCO CA
94118-1429
US

V. Phone/Fax

Practice location:
  • Phone: 415-379-9972
  • Fax: 415-751-4647
Mailing address:
  • Phone: 415-379-9972
  • Fax: 415-751-4647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number344658
License Number StateCA

VIII. Authorized Official

Name: MR. ARKADIY RABINOVICH
Title or Position: OWNER
Credential:
Phone: 415-379-9972