Healthcare Provider Details
I. General information
NPI: 1619275021
Provider Name (Legal Business Name): APOLLO FAMILY MEDICINE AND SLEEP MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/09/2011
Last Update Date: 08/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
950 STOCKTON ST SUITE 200
SAN FRANCISCO CA
94108-1633
US
IV. Provider business mailing address
PO BOX 8221
FOSTER CITY CA
94404-8221
US
V. Phone/Fax
- Phone: 415-398-9861
- Fax: 415-398-4718
- Phone: 415-398-9861
- Fax: 415-398-4718
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084S0012X |
| Taxonomy | Sleep Medicine (Psychiatry & Neurology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WENGUANG
KEVIN
ZHAO
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 650-504-6640