Provider Demographics
NPI:1033312962
Name:ON LOK SENIOR HEALTH SERVICES
Entity Type:Organization
Organization Name:ON LOK SENIOR HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:LI
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-292-8883
Mailing Address - Street 1:1333 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5611
Mailing Address - Country:US
Mailing Address - Phone:415-292-8888
Mailing Address - Fax:
Practice Address - Street 1:225 30TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94131-2420
Practice Address - Country:US
Practice Address - Phone:415-550-2230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA070000547261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAADU70062HMedicare ID - Type UnspecifiedADULT DAY HEALTH CENTER