Healthcare Provider Details

I. General information

NPI: 1518144310
Provider Name (Legal Business Name): LAGUNA HONDA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 LAGUNA HONDA BLVD
SAN FRANCISCO CA
94116-1411
US

IV. Provider business mailing address

1001 POTRERO AVE BLDG 10
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-759-3348
  • Fax: 415-759-3012
Mailing address:
  • Phone: 415-206-8338
  • Fax: 415-206-3837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. DIANA GUEVARA
Title or Position: HOSP ASSOC ADMIN, PATIENT FIN SERV
Credential:
Phone: 415-206-3286