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General NPI Number Information
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NPI Number | 1003215914
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Entity Type | Organization
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Legal Business Name | INSTITUTE ON AGING
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 06/27/2022
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Provider Practice Location Address
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Address Line | 3575 GEARY BLVD
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3212
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Country | US
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Telephone | 415-750-4101
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Fax |
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Provider Business Mailing Address
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Address Line | 3575 GEARY BLVD
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3212
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Country | US
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Telephone | 415-750-4101
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | ROXANA R BLADES
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Credential |
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Telephone | 415-750-4101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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