Provider Demographics
NPI:1053857706
Name:5 DIRECTION INTEGRATIVE VETERINARY CARE
Entity Type:Organization
Organization Name:5 DIRECTION INTEGRATIVE VETERINARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BECK YUEN
Authorized Official - Last Name:FONG
Authorized Official - Suffix:
Authorized Official - Credentials:DVM, LAC
Authorized Official - Phone:415-418-4550
Mailing Address - Street 1:32 ULLOA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1218
Mailing Address - Country:US
Mailing Address - Phone:415-418-4550
Mailing Address - Fax:
Practice Address - Street 1:32 ULLOA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94127-1218
Practice Address - Country:US
Practice Address - Phone:415-418-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVET 15620284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital