| NPI | 1417875956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL SHEROCK Credentialing Manager 415-636-9987 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine | |
| Enumeration Date | 2026-07-09 |
| Last Update Date | 2026-07-09 |