Healthcare Provider Details

I. General information

NPI: 1881639417
Provider Name (Legal Business Name): RONALD HENRY LABUGUEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 11/04/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 ILLINOIS ST.
SAN FRANCISCO CA
94158
US

IV. Provider business mailing address

995 POTRERO AVE BLDG 80 WARD 83
SAN FRANCISCO CA
94110-2859
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-9414
  • Fax: 415-476-4689
Mailing address:
  • Phone: 415-206-8446
  • Fax: 415-206-8387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA81418
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: