Healthcare Provider Details

I. General information

NPI: 1730691296
Provider Name (Legal Business Name): ACCESS PRIMARY CARE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2017
Last Update Date: 10/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 VALENCIA ST STE 111
SAN FRANCISCO CA
94110-4415
US

IV. Provider business mailing address

1580 VALENCIA ST STE 111
SAN FRANCISCO CA
94110-4415
US

V. Phone/Fax

Practice location:
  • Phone: 650-303-0220
  • Fax: 650-991-1800
Mailing address:
  • Phone: 650-303-0220
  • Fax: 650-991-1800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. LAWRENCE CHAO
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 415-333-3302