Healthcare Provider Details

I. General information

NPI: 1649389768
Provider Name (Legal Business Name): MICHEL FARID ACCAD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 VAN NESS AVE SUITE 208
SAN FRANCISCO CA
94109-3023
US

IV. Provider business mailing address

2000 VAN NESS AVENUE SUITE 208
SAN FRANCISCO CA
94109-3023
US

V. Phone/Fax

Practice location:
  • Phone: 415-567-1014
  • Fax: 415-567-1015
Mailing address:
  • Phone: 415-567-1014
  • Fax: 415-567-1015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA63434
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA63434
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA63434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: