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General NPI Number Information
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NPI Number | 1629561170
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Entity Type | Individual
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Provider Name | JOHN BENJAMIN JESS AREVALO MD, MBA
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Gender | Male
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Dates
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Enumeration Date | 06/10/2018
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 520 ILLINOIS ST FL 4
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2501
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Country | US
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Telephone | 415-885-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 520 ILLINOIS ST FL 4
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2501
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Country | US
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Telephone | 415-885-7246
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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 | 207PH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Emergency Medicine) Physician
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License Number | 1015248
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | A174705
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 1015248
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | A174705
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License Number State | CA
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