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General NPI Number Information
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NPI Number | 1265170476
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Entity Type | Organization
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Legal Business Name | PRIMARY DIAGNOSTICS MEDICAL GROUP OF KANSAS P.A.
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Dates
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Enumeration Date | 05/26/2022
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 99 OSGOOD PL STE 500
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City | SAN FRANCISCO
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State | CA
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Zip | 94133-4629
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Country | US
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Telephone | 415-746-9639
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Fax |
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Provider Business Mailing Address
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Address Line | 595 PACIFIC AVE FL 4
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City | SAN FRANCISCO
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State | CA
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Zip | 94133-4685
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Country | US
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Telephone | 855-907-3223
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANDREW KOBYLINSKI
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Credential |
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Telephone | 415-746-9639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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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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