Healthcare Provider Details

I. General information

NPI: 1528166758
Provider Name (Legal Business Name): FINANCIAL DIST MED ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 MONTGOMERY ST SUITE 420
SAN FRANCISCO CA
94104
US

IV. Provider business mailing address

220 MONTGOMERY ST SUITE 420
SAN FRANCISCO CA
94104-3560
US

V. Phone/Fax

Practice location:
  • Phone: 415-433-7000
  • Fax: 415-434-4509
Mailing address:
  • Phone: 415-433-7000
  • Fax: 415-434-4509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberA77829
License Number StateCA

VIII. Authorized Official

Name: DR. DAN ALAN KALSHAN
Title or Position: PRESIDENT
Credential: MD
Phone: 415-433-7000