Provider Demographics
NPI:1033485602
Name:JOHN W PIERCE MD
Entity Type:Organization
Organization Name:JOHN W PIERCE MD
Other - Org Name:LOS PORTALES FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-826-2438
Mailing Address - Street 1:2480 MISSION ST STE 329
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2487
Mailing Address - Country:US
Mailing Address - Phone:415-826-2438
Mailing Address - Fax:415-826-2702
Practice Address - Street 1:2480 MISSION ST STE 329
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2487
Practice Address - Country:US
Practice Address - Phone:415-826-2438
Practice Address - Fax:415-826-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG45225207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty