Healthcare Provider Details

I. General information

NPI: 1588695159
Provider Name (Legal Business Name): R.C. DAVID MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 MISSION ST SUITE 215
SAN FRANCISCO CA
94110-2468
US

IV. Provider business mailing address

2480 MISSION ST SUITE 215
SAN FRANCISCO CA
94110-2468
US

V. Phone/Fax

Practice location:
  • Phone: 415-824-6400
  • Fax: 415-821-0657
Mailing address:
  • Phone: 415-824-6400
  • Fax: 415-821-0657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA53612
License Number StateCA

VIII. Authorized Official

Name: DR. ROMEO C DAVID
Title or Position: PRESIDENT
Credential: M. D.
Phone: 650-588-2240