| San Francisco Digestive Disease Medical Group Inc A Prof Corp | |
|
1 Shrader St Ste 500 San Francisco CA 94117-1044 | |
| (415) 362-3336 | |
| (415) 362-7542 |
| Full Name | San Francisco Digestive Disease Medical Group Inc A Prof Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 Shrader St Ste 500, San Francisco, California |
| Authorized Official Name and Position | Gregory Fung (PRESIDENT) |
| Authorized Official Contact | 4153623336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Francisco Digestive Disease Medical Group Inc A Prof Corp 1 Shrader St Ste 500 San Francisco CA 94117-1044 Ph: (415) 362-3336 | San Francisco Digestive Disease Medical Group Inc A Prof Corp 1 Shrader St Ste 500 San Francisco CA 94117-1044 Ph: (415) 362-3336 |
| NPI Number | 1417017435 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 05/14/2019 |
| Medicare PECOS PAC ID | 1759445240 |
|---|---|
| Medicare Enrollment ID | O20090128000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417017435 | NPI | - | NPPES |
| 1417017435 | Other | CA | MEDICARE NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Gregory Fung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700970795 PECOS PAC ID: 5799846168 Enrollment ID: I20081203000520 |
| Provider Name | Kevin Michael Man |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841350832 PECOS PAC ID: 9032216346 Enrollment ID: I20090128000388 |
| Provider Name | James Henry Reed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851451934 PECOS PAC ID: 7113024423 Enrollment ID: I20090128000424 |
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