Healthcare Provider Details

I. General information

NPI: 1154543254
Provider Name (Legal Business Name): ST. JAMES INFIRMARY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 POLK ST FL 4
SAN FRANCISCO CA
94109
US

IV. Provider business mailing address

730 POLK ST FL 4
SAN FRANCISCO CA
94109-7813
US

V. Phone/Fax

Practice location:
  • Phone: 415-554-8494
  • Fax: 415-554-8444
Mailing address:
  • Phone: 415-554-8494
  • Fax: 415-554-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number220000498
License Number StateCA

VIII. Authorized Official

Name: MS. CATHERINE SWANSON
Title or Position: MEDICAL RECORDS COORDINATOR
Credential: MPH
Phone: 415-554-8494