Provider Demographics
NPI:1831556778
Name:OFFICEMD, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:OFFICEMD, A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRENIER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-722-2440
Mailing Address - Street 1:490 POST ST STE 900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1410
Mailing Address - Country:US
Mailing Address - Phone:415-362-7177
Mailing Address - Fax:415-962-1317
Practice Address - Street 1:490 POST ST STE 900
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1410
Practice Address - Country:US
Practice Address - Phone:415-362-7177
Practice Address - Fax:415-962-1317
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OFFICEMD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-22
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty