Healthcare Provider Details

I. General information

NPI: 1831025204
Provider Name (Legal Business Name): SAN FRANCISCO CONCIERGE PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SUTTER ST RM 1822
SAN FRANCISCO CA
94108-4111
US

IV. Provider business mailing address

450 SUTTER ST RM 1822
SAN FRANCISCO CA
94108-4111
US

V. Phone/Fax

Practice location:
  • Phone: 415-706-8993
  • Fax:
Mailing address:
  • Phone: 415-706-8993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIO ALBERTO BENITEZ-LOPEZ
Title or Position: CEO
Credential: MD
Phone: 415-706-8993