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General NPI Number Information
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NPI Number | 1578638185
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Entity Type | Organization
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Legal Business Name | J RONALD BEAN MEDICAL CORPORATION
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4333 CALIFORNIA STREET
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1376
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Country | US
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Telephone | 415-923-0400
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Fax | 415-666-3176
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Provider Business Mailing Address
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Address Line | PO BOX # 597004 PMB# 736
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City | SAN FRANCISCO
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State | CA
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Zip | 94159-7004
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Country | US
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Telephone | 415-923-0400
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Fax | 415-666-3176
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Authorized Official
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Title or Position | PRESIDENT J RONALD BEAN MED CORP
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Name | DR. JOHN RONALD BEAN
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Credential | MD
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Telephone | 415-923-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A201230
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License Number State | CA
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