Healthcare Provider Details

I. General information

NPI: 1558390716
Provider Name (Legal Business Name): ST LUKES HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 08/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 VALENCIA ST SUITE 506
SAN FRANCISCO CA
94110-4403
US

IV. Provider business mailing address

3555 CESAR CHAVEZ REDWOOD ESTATE BLDG
SAN FRANCISCO CA
94110-4403
US

V. Phone/Fax

Practice location:
  • Phone: 415-641-2140
  • Fax: 415-641-5152
Mailing address:
  • Phone: 415-641-2177
  • Fax: 415-641-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: MS. AGNES LAU
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 415-641-2177