Wavecrest Medicine, INC.
Clinic/Center, Primary Care in Daly City, CA. Organization (NPI-2).
NPI number1619087988
StatusActive
Last updated in NPPESOct 3, 2011
Details
- NPI
- 1619087988
- Entity type
- Organization (NPI-2)
- Legal business name
- Wavecrest Medicine, INC.
- Organization subpart
- No
- Enumeration date
- Aug 30, 2006
- Last updated
- Oct 3, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Practice location
1850 Sullivan AveSuite 320
Daly City, CA 94015-2221
Phone 650-985-0530 · Fax 650-985-0535
Mailing address
1850 Sullivan AveSuite 320
Daly City, CA 94015-2221
Phone 650-985-0530 · Fax 650-985-0535
Authorized official
Kris C Kealey
Ceo
6509850530
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