Healthcare Provider Details

I. General information

NPI: 1437062551
Provider Name (Legal Business Name): ENZOSH PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WEBSTER ST STE 314
SAN FRANCISCO CA
94115-2377
US

IV. Provider business mailing address

2100 WEBSTER ST STE 314
SAN FRANCISCO CA
94115-2377
US

V. Phone/Fax

Practice location:
  • Phone: 415-737-0555
  • Fax: 415-737-0595
Mailing address:
  • Phone: 415-737-0555
  • Fax: 415-737-0595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. RAYSHAD OSHTORY
Title or Position: OWNER
Credential: MD
Phone: 415-737-0555