Basic Information
| Provider Information | |||||||||
| NPI: | 1366534091 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LAPAROSCOPIC ASSOCIATES OF SAN FRANCISCO MEDICAL GROUP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 WEBSTER ST | ||||||||
| Address2: | STE 518 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941152373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153318390 | ||||||||
| FaxNumber: | 4153318380 | ||||||||
| Practice Location | |||||||||
| Address1: | 2100 WEBSTER ST | ||||||||
| Address2: | STE 518 | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941152373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4153318390 | ||||||||
| FaxNumber: | 4153318380 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2006 | ||||||||
| LastUpdateDate: | 07/13/2007 | ||||||||
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| AuthorizedOfficialLastName: | JOSSART | ||||||||
| AuthorizedOfficialFirstName: | GREGG | ||||||||
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| AuthorizedOfficialTitleorPosition: | PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 4153318390 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | G750720 | CA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.