Healthcare Provider Details

I. General information

NPI: 1144528324
Provider Name (Legal Business Name): NATIVE AMERICAN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 CAPP ST,
SAN FRANCISCO CA
94110-1210
US

IV. Provider business mailing address

160 CAPP ST,
SAN FRANCISCO CA
94102
US

V. Phone/Fax

Practice location:
  • Phone: 415-553-6621
  • Fax:
Mailing address:
  • Phone: 415-621-8051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MARK ESPINOSA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 415-553-6621