Healthcare Provider Details

I. General information

NPI: 1629498118
Provider Name (Legal Business Name): HEALTHRIGHT 360
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 02/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1833 FILLMORE ST FL 3
SAN FRANCISCO CA
94115-3181
US

IV. Provider business mailing address

1563 MISSION STREET, 4TH FLOOR
SAN FRANCISCO CA
94103-2543
US

V. Phone/Fax

Practice location:
  • Phone: 415-379-7800
  • Fax: 415-865-0119
Mailing address:
  • Phone: 415-762-3700
  • Fax: 415-379-7804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VITKA EISEN
Title or Position: CEO
Credential:
Phone: 415-762-3700