Provider Demographics
NPI:1902826456
Name:ASTHMA & ALLERGY CLINIC OF MARIN & SAN FRANCISCO
Entity Type:Organization
Organization Name:ASTHMA & ALLERGY CLINIC OF MARIN & SAN FRANCISCO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCHUMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-751-6800
Mailing Address - Street 1:6850 GEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-1604
Mailing Address - Country:US
Mailing Address - Phone:415-751-6800
Mailing Address - Fax:415-751-6808
Practice Address - Street 1:6850 GEARY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94121-1604
Practice Address - Country:US
Practice Address - Phone:415-751-6800
Practice Address - Fax:415-751-6808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG063486174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF15353Medicare UPIN
CAE25200Medicare UPIN
CAH25862Medicare UPIN