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NPI Code Detail

MEDICARE: BRILLIANT CORNERS

MEDICARE: BRILLIANT CORNERS
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
1251B00000XCase Management Agency
2171WH0202XHome Modifications Contractor
3251X00000XSupports Brokerage Agency

General Provider Information

NPI Number : 1356687354
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRILLIANT CORNERS
Provider Business Mailing Address
First Line : 854 FOLSOM ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94107-1123
Country : US
Telephone Number : 415-618-0012
Fax Number :
Provider Business Practice Location Address
First Line : 854 FOLSOM ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94107-1123
Country : US
Telephone Number : 415-618-0012
Fax Number :
Authorized Official
Title or Position : DEPUTY CHIEF OPERATING OFFICER
Name : TYLER FONG
Credential :
Telephone Number : 415-618-0012
Provider Enumeration Date : 12/19/2012
Last Update Date : 12/02/2025

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1063612364 — MS. SHEILAH ELIZABETH ROGERS L.AC.
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Directions to “BRILLIANT CORNERS ” Practice Location

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