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General NPI Number Information
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NPI Number | 1295805091
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Entity Type | Individual
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Provider Name | ROBERT ALFRED BUSH JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 10/18/2017
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Provider Practice Location Address
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Address Line | 17 BEAVER ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-1514
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Country | US
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Telephone | 415-621-8175
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Fax | 415-252-8131
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Provider Business Mailing Address
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Address Line | 2261 MARKET ST # 158
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City | SAN FRANCISCO
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State | CA
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Zip | 94114-1600
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Country | US
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Telephone | 415-621-8175
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A23336
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License Number State | CA
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