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General NPI Number Information
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NPI Number | 1225218662
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASES CONSULTANTS MEDICAL GRUP INC
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 06/17/2010
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Provider Practice Location Address
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Address Line | 1339 4TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2615
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Country | US
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Telephone | 415-681-9980
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Fax |
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Provider Business Mailing Address
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Address Line | 1339 4TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-2615
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Country | US
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Telephone | 415-681-9980
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANK RYNING
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Credential | M.D.
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Telephone | 415-681-9980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | G29459
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License Number State | CA
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