Provider Demographics
NPI:1215000211
Name:SAN FRANCISCO CRITICAL CARE MED GROUP INC
Entity Type:Organization
Organization Name:SAN FRANCISCO CRITICAL CARE MED GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-923-3421
Mailing Address - Street 1:1100 VAN NESS AVE STE 1005
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-6980
Mailing Address - Country:US
Mailing Address - Phone:415-923-3421
Mailing Address - Fax:415-243-8666
Practice Address - Street 1:1100 VAN NESS AVE STE 1005
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-6980
Practice Address - Country:US
Practice Address - Phone:415-923-3421
Practice Address - Fax:415-243-8666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50990207RC0200X, 207RP1001X
207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0089300OtherMEDI CAL
CA00G790231Medicare ID - Type UnspecifiedDR NOREEN ROTH HENIG
CA00A633390Medicare ID - Type UnspecifiedDR IVAN CHENG
CA00A796120Medicare ID - Type UnspecifiedDR GORDANA BJEKIC
CA00A788881Medicare PIN
CA00A783360Medicare ID - Type UnspecifiedDR MICHAEL YIM
CAGR0089300OtherMEDI CAL
ZZZ18892ZMedicare UPIN
CA009509900Medicare ID - Type UnspecifiedDR CHRISTOPHER R BROWN