Provider Demographics
NPI:1376271874
Name:OPT HEALTH CA PC
Entity Type:Organization
Organization Name:OPT HEALTH CA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:GHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-730-6229
Mailing Address - Street 1:595 PACIFIC AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-4685
Mailing Address - Country:US
Mailing Address - Phone:610-730-6229
Mailing Address - Fax:
Practice Address - Street 1:595 PACIFIC AVE FL 4
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-4685
Practice Address - Country:US
Practice Address - Phone:610-730-6229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty