Provider Demographics
NPI:1265496301
Name:POSADA, JUAN ESTEBAN (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:ESTEBAN
Last Name:POSADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54533207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1851590780OtherRENDERING NPI
CAA54533OtherSTATE LINCENSE
CAG45811Medicare UPIN
CAZZZ26145ZMedicare PIN
CA1851590780OtherRENDERING NPI