Provider Demographics
NPI:1871009761
Name:MOTION MEDICAL GROUP
Entity Type:Organization
Organization Name:MOTION MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-408-7557
Mailing Address - Street 1:480 2ND ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1429
Mailing Address - Country:US
Mailing Address - Phone:415-408-7557
Mailing Address - Fax:844-364-0141
Practice Address - Street 1:480 2ND ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107
Practice Address - Country:US
Practice Address - Phone:415-408-7557
Practice Address - Fax:844-364-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31737111NS0005X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty