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General NPI Number Information
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NPI Number | 1790069235
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Entity Type | Organization
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Legal Business Name | PREMIER ORTHOPEDIC SURGEON HOSPITALISTS
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 1900 SULLIVAN AVE ATTN: PAMELA DAVIS
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City | DALY CITY
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State | CA
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Zip | 94015-2200
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Country | US
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Telephone | 650-991-5819
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Fax | 650-991-6743
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Provider Business Mailing Address
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Address Line | 1850 SULLIVAN AVE #150
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City | DALY CITY
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State | CA
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Zip | 94015-2221
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Country | US
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Telephone | 650-991-5880
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Fax | 650-991-5889
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERTO BOLANOS
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Credential | M.D.
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Telephone | 650-991-5880
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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 |
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License Number State |
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