Healthcare Provider Details

I. General information

NPI: 1710513692
Provider Name (Legal Business Name): UNKNOWN SEER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 MISSION ST
SAN FRANCISCO CA
94103-2417
US

IV. Provider business mailing address

1735 MISSION ST
SAN FRANCISCO CA
94103-2417
US

V. Phone/Fax

Practice location:
  • Phone: 415-565-7667
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number317407
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA198124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: