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General NPI Number Information
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NPI Number | 1699166462
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Entity Type | Organization
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Legal Business Name | JOHN O. MISSIRIAN, MD. INC
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 839 MARINA BLVD
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-1024
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Country | US
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Telephone | 415-298-6575
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Fax | 415-292-3659
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Provider Business Mailing Address
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Address Line | 839 MARINA BLVD
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City | SAN FRANCISCO
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State | CA
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Zip | 94123-1024
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Country | US
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Telephone | 415-298-6575
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Fax | 415-292-3659
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN O. MISSIRIAN
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Credential | MD
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Telephone | 415-298-6575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | C37815
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License Number State | CA
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