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NPI Code Detail

MEDICARE: ON LOK SENIOR HEALTH SERVICES

MEDICARE: ON LOK SENIOR HEALTH SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1302R00000XHealth Maintenance Organization9330385CA
2251T00000XPACE Provider Organization

General Provider Information

NPI Number : 1043218134
Entity Type Code : Organization
Provider Name (Legal Business Name) : ON LOK SENIOR HEALTH SERVICES
Provider Business Mailing Address
First Line : 1333 BUSH ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-5611
Country : US
Telephone Number : 415-292-8888
Fax Number : 415-292-8745
Provider Business Practice Location Address
First Line : 1333 BUSH ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94109-5611
Country : US
Telephone Number : 415-292-8888
Fax Number : 415-292-8745
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : GRACE LI HARPER
Credential :
Telephone Number : 415-292-8883
Provider Enumeration Date : 07/12/2005
Last Update Date : 05/13/2022

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1508867128 — CAREN SHEILA GOULD M.D.
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1558363978 — DEBORAH DANG M.D.
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1710979190 — CAROL ANNE LIM GNP
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Directions to “ON LOK SENIOR HEALTH SERVICES ” Practice Location

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