Healthcare Provider Details

I. General information

NPI: 1467109793
Provider Name (Legal Business Name): PROSALUD FAMILY MEDICINE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 MISSION ST STE 221
SAN FRANCISCO CA
94110-2485
US

IV. Provider business mailing address

2480 MISSION ST STE 221
SAN FRANCISCO CA
94110-2485
US

V. Phone/Fax

Practice location:
  • Phone: 628-223-5395
  • Fax:
Mailing address:
  • Phone: 628-223-5395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JUAN E POSADA
Title or Position: OWNER
Credential: MD
Phone: 628-223-5395