Healthcare Provider Details

I. General information

NPI: 1447359310
Provider Name (Legal Business Name): RENAL MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER ST STE 320
SAN FRANCISCO CA
94115-2377
US

IV. Provider business mailing address

2100 WEBSTER ST STE 320
SAN FRANCISCO CA
94115-2377
US

V. Phone/Fax

Practice location:
  • Phone: 415-923-3456
  • Fax: 415-923-3121
Mailing address:
  • Phone: 415-923-3456
  • Fax: 415-923-3121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL F BORAH
Title or Position: PRESIDENT
Credential: MD
Phone: 415-923-3456