Pediatric Associates
Physician Assistant in San Francisco, CA. Organization (NPI-2).
NPI number1366735581
StatusActive
Last updated in NPPESApr 16, 2025
Details
- NPI
- 1366735581
- Entity type
- Organization (NPI-2)
- Legal business name
- Pediatric Associates
- Organization subpart
- Yes
- Enumeration date
- May 20, 2011
- Certification date
- Apr 16, 2025
- Last updated
- Apr 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 220000091 | CA | Yes |
| 363AM0700X | Physician Assistant, Medical | 220000091 | CA | |
| 363AS0400X | Physician Assistant, Surgical | 220000091 | CA |
Practice location
400 Parnassus AveSan Francisco, CA 94143-2202
Phone 415-476-1000
Mailing address
1635 Divisadero StSte 625
San Francisco, CA 94143-1821
Phone 415-476-4029
Authorized official
Dave Rein
Cfo
4154764003
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