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General NPI Number Information
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NPI Number | 1407404379
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Entity Type | Organization
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Legal Business Name | UNION SQUARE SURGERY CENTER, PC
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Dates
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Enumeration Date | 09/03/2019
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Last Update Date | 09/03/2019
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Provider Practice Location Address
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Address Line | 421 POST ST FL 14
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-1501
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Country | US
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Telephone | 415-767-1919
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Fax | 415-941-3119
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Provider Business Mailing Address
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Address Line | 421 POST ST FL 14
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City | SAN FRANCISCO
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State | CA
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Zip | 94102-1501
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Country | US
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Telephone | 415-767-1919
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Fax | 415-941-3119
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Authorized Official
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Title or Position | CEO
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Name | DR. JOHN ADEMOLA
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Credential | PHD
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Telephone | 415-845-4638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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