MEDICARE: DIRECT PRIMARY CARE STAFFING, PLLC

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	207R00000X	Internal Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1396534301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIRECT PRIMARY CARE STAFFING, PLLC

Provider Business Mailing Address
First Line	:	1 EMBARCADERO CTR STE 1900
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-3723
Country	:	US
Telephone Number	:	415-658-6791
Fax Number	:	415-520-0904

Provider Business Practice Location Address
First Line	:	8175 SHERIDAN BLVD
Second Line	:
City	:	ARVADA
State	:	CO
Zip	:	80003-1956
Country	:	US
Telephone Number	:	888-663-6331
Fax Number	:	415-252-7176

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	ANDREW S DIAMOND
Credential	:
Telephone Number	:	415-689-3426

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	05/05/2025

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