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General NPI Number Information
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NPI Number | 1093225138
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Entity Type | Organization
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Legal Business Name | VIRTA MEDICAL P.C.
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 655 MONTGOMERY ST STE 810
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-2677
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Country | US
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Telephone | 844-847-8216
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Fax | 415-520-9150
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Provider Business Mailing Address
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Address Line | 655 MONTGOMERY ST STE 810
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-2677
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Country | US
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Telephone | 844-847-8216
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Fax | 415-520-9150
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY PETERSON STANLEY
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Credential | MD
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Telephone | 844-847-8216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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