Provider Demographics
NPI:1831680198
Name:PLASCENCIA, LUISALFREDO
Entity Type:Individual
Prefix:MR
First Name:LUISALFREDO
Middle Name:
Last Name:PLASCENCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:LUIS
Other - Middle Name:
Other - Last Name:PLASCENCIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA & EDM
Mailing Address - Street 1:325 SUTTER ST # 521
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2919 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3917
Practice Address - Country:US
Practice Address - Phone:415-229-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program