Provider Demographics
NPI:1467109793
Name:PROSALUD FAMILY MEDICINE, INC
Entity Type:Organization
Organization Name:PROSALUD FAMILY MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:POSADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:628-223-5395
Mailing Address - Street 1:2480 MISSION ST STE 221
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2485
Mailing Address - Country:US
Mailing Address - Phone:628-223-5395
Mailing Address - Fax:
Practice Address - Street 1:2480 MISSION ST STE 221
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2485
Practice Address - Country:US
Practice Address - Phone:628-223-5395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty