Healthcare Provider Details

I. General information

NPI: 1790854578
Provider Name (Legal Business Name): JONATHAN MICHAEL VRBAN N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JONATHAN MICHAEL VRBAN N.P.

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 GEARY BLVD EMPLOYEE HEALTH
SAN FRANCISCO CA
94115-3358
US

IV. Provider business mailing address

1980 VALLEJO ST NINTH FLOOR
SAN FRANCISCO CA
94123-4962
US

V. Phone/Fax

Practice location:
  • Phone: 415-833-6355
  • Fax: 415-833-6471
Mailing address:
  • Phone: 415-563-1440
  • Fax: 415-563-3216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP 11632
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: