Provider Demographics
NPI:1043218134
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:415-292-8745
Practice Address - Street 1:1333 BUSH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-5611
Practice Address - Country:US
Practice Address - Phone:415-292-8888
Practice Address - Fax:415-292-8745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251T00000X
CA9330385302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization