Healthcare Provider Details

I. General information

NPI: 1053689794
Provider Name (Legal Business Name): MEDLINK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 MONTGOMERY ST
SAN FRANCISCO CA
94111-1008
US

IV. Provider business mailing address

1613 MONTGOMERY ST
SAN FRANCISCO CA
94111-1008
US

V. Phone/Fax

Practice location:
  • Phone: 415-399-9769
  • Fax:
Mailing address:
  • Phone: 415-399-9769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: MS. JANICE HARIS
Title or Position: CEO
Credential:
Phone: 415-399-9769