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General NPI Number Information
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NPI Number | 1780457812
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Entity Type | Organization
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Legal Business Name | PREMISE HEALTH OF CALIFORNIA MEDICAL, P.C
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Dates
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Enumeration Date | 10/31/2023
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 345 SPEAR ST FL SF5
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-1673
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Country | US
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Telephone | 415-429-5461
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Fax | 415-723-7424
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Provider Business Mailing Address
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Address Line | 5500 MARYLAND WAY STE 120
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City | BRENTWOOD
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State | TN
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Zip | 37027-4993
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LEGAL COUNSEL
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Name | WILL WRIGHT
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Credential |
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Telephone | 615-577-5893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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