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General NPI Number Information
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NPI Number | 1740972108
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Entity Type | Organization
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Legal Business Name | RAFIK SIDAROS, M.D. INC.
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Dates
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Enumeration Date | 05/24/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 595 BUCKINGHAM WAY STE 505
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1913
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Country | US
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Telephone | 415-758-0932
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Fax |
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Provider Business Mailing Address
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Address Line | 7 W 41ST AVE # 213
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City | SAN MATEO
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State | CA
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Zip | 94403-5105
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Country | US
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Telephone | 415-758-0932
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. RAFIK SIDAROS
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Credential | MD
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Telephone | 415-758-0932
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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 |
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License Number State |
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