Provider Demographics
NPI:1154464360
Name:PET IMAGING OF SAN FRANCISCO
Entity Type:Organization
Organization Name:PET IMAGING OF SAN FRANCISCO
Other - Org Name:PET IMAGING OF THE PENINSULA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CURT
Authorized Official - Middle Name:
Authorized Official - Last Name:HIMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-771-5700
Mailing Address - Street 1:1700 CALIFORNIA ST STE 480
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4590
Mailing Address - Country:US
Mailing Address - Phone:415-771-5700
Mailing Address - Fax:415-771-3200
Practice Address - Street 1:1700 CALIFORNIA ST STE 480
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4590
Practice Address - Country:US
Practice Address - Phone:415-771-5700
Practice Address - Fax:415-771-3200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6895412471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine TechnologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIDTF00110Medicaid
CAZZZ22378ZMedicare ID - Type UnspecifiedPROVIDER IDENTIFIER