Provider Demographics
NPI:1649729203
Name:SAN FRANCISCO ORTHOPAEDIC SURGEONS
Entity type:Organization
Organization Name:SAN FRANCISCO ORTHOPAEDIC SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DMITRI
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBEDEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-213-0215
Mailing Address - Street 1:1 SHRADER ST
Mailing Address - Street 2:STE 650
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1016
Mailing Address - Country:US
Mailing Address - Phone:415-221-0665
Mailing Address - Fax:
Practice Address - Street 1:1 SHRADER ST
Practice Address - Street 2:650
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1016
Practice Address - Country:US
Practice Address - Phone:415-221-0665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ48419ZMedicare PIN