Healthcare Provider Details

I. General information

NPI: 1154464360
Provider Name (Legal Business Name): PET IMAGING OF SAN FRANCISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CALIFORNIA ST STE 480
SAN FRANCISCO CA
94109-4590
US

IV. Provider business mailing address

1700 CALIFORNIA ST STE 480
SAN FRANCISCO CA
94109-4590
US

V. Phone/Fax

Practice location:
  • Phone: 415-771-5700
  • Fax: 415-771-3200
Mailing address:
  • Phone: 415-771-5700
  • Fax: 415-771-3200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471N0900X
TaxonomyNuclear Medicine Technology Radiologic Technologist
License Number689541
License Number StateCA

VIII. Authorized Official

Name: MR. CURT HIMY
Title or Position: PRESIDENT
Credential:
Phone: 415-771-5700