MEDICARE: REFRAME HEALTHCARE MEDICAL GROUP

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
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1275212276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFRAME HEALTHCARE MEDICAL GROUP

Provider Business Mailing Address
First Line	:	447 SUTTER ST STE 405
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94108-4618
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12828 WILLOW CENTRE DR
Second Line	:	STE D #19
City	:	HOUSTON
State	:	TX
Zip	:	77066-3043
Country	:	US
Telephone Number	:	415-917-1886
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JESSICA BELL VAN DER WAL
Credential	:
Telephone Number	:	415-275-2574

Provider Enumeration Date	:	07/17/2023
Last Update Date	:	11/22/2024

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