Provider Demographics
NPI:1134110661
Name:SAN FRANCISCO EMERGENCY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:SAN FRANCISCO EMERGENCY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROOKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-244-2886
Mailing Address - Street 1:PO BOX 1606
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-1606
Mailing Address - Country:US
Mailing Address - Phone:415-531-3809
Mailing Address - Fax:781-430-8128
Practice Address - Street 1:370 S MORNING SUN AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3862
Practice Address - Country:US
Practice Address - Phone:415-244-2886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0080560Medicaid
CAZZZ5648IZOtherBLUE SHIELD
CAZZZ5648IZOtherBLUE SHIELD