Healthcare Provider Details

I. General information

NPI: 1215264882
Provider Name (Legal Business Name): ORTHOPAEDIC XRAY OF SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 11/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CALIFORNIA ST #300
SAN FRANCISCO CA
94109
US

IV. Provider business mailing address

1800 SULLIVAN AVE #402
DALY CITY CA
94015
US

V. Phone/Fax

Practice location:
  • Phone: 415-346-4400
  • Fax:
Mailing address:
  • Phone: 650-992-7700
  • Fax: 650-756-6254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL SCHRUPP
Title or Position: MANAGER
Credential:
Phone: 650-992-7700