Tides Center
Exclusive Provider Organization in San Francisco, CA. Organization (NPI-2).
NPI number1083940969
StatusActive
Last updated in NPPESOct 27, 2009
Details
- NPI
- 1083940969
- Entity type
- Organization (NPI-2)
- Legal business name
- Tides Center
- Organization subpart
- No
- Enumeration date
- Oct 27, 2009
- Last updated
- Oct 27, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 302F00000X | Exclusive Provider Organization | – | – | Yes |
Practice location
1014 Torney AveSan Francisco, CA 94129-1755
Phone 415-561-6300
Mailing address
1014 Torney AveSan Francisco, CA 94129-1755
Authorized official
Alvin Lee
Government Grants Manager
4155616309
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 8 Exclusive Provider Organization providers in San Francisco · All 43,681 providers in San Francisco
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