Healthcare Provider Details
I. General information
NPI: 1447447248
Provider Name (Legal Business Name): PACIFIC INPATIENT MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/26/2007
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1101 VAN NESS AVE
SAN FRANCISCO CA
94109-6919
US
IV. Provider business mailing address
601 VAN NESS AVE STE E3619
SAN FRANCISCO CA
94102-3200
US
V. Phone/Fax
- Phone: 415-531-9047
- Fax: 415-213-4659
- Phone: 415-531-9047
- Fax: 415-213-4659
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FABIOLA
COBARRUBIAS
Title or Position: CEO
Credential:
Phone: 415-215-0931