MARINA HARBOR DETOX


Address: 289 Marina Blvd, San Francisco, CA 94123-1212
Phone: 4158683858

MARINA HARBOR DETOX (NPI# 1720624497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1720624497
Entity Type Organization
Organization Name MARINA HARBOR DETOX
Practice Address 289 Marina Blvd
San Francisco
CA 94123-1212
Practice Telephone 4158683858
Mailing Telephone 4158683858
Enumeration Date 2019-11-18
Last Update Date 2019-11-18
Authorized Official Name JOHN E TERWELP (EXECUTIVE DIRECTOR)
Authorized Official Telephone 9255950871
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QA0401X Family Medicine
Specialization: Addiction Medicine
Allopathic & Osteopathic Physicians

Office Location

Street Address 289 MARINA BLVD
City SAN FRANCISCO
State CA
Zip Code 94123-1212

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437611357 Sarah Wenton Alexander Occupational Therapist 3007 Fillmore Street #3, San Francisco, CA 94123 2019-04-01
1306203138 Cora Ann Keene Marriage & Family Therapist 1795 Union St, San Francisco, CA 94123 2016-01-25
1437556818 Haley Alexander Behavioral Analyst 3750 Scott St Apt 205, San Francisco, CA 94123 2014-12-01
1992055040 Robert J Buonfiglio Psychologist 1738 Union Street # 302, San Francisco, CA 94123 2012-09-17
1750656732 Jane C Freston Occupational Therapist 1849 Chestnut Street, Apartment 4, San Francisco, CA 94123 2012-03-09
1700114212 Marlene Ellen Kushner Marriage & Family Therapist 2918 Webster Street, San Francisco, CA 94123 2009-11-20
1487980447 Acupuncture for Athletics Acupuncturist 1996 Union Street, 3rd Floor, San Francisco, CA 94123 2009-10-27
1104054436 Sarah Elizabeth Bothe Psychologist 1738 Union Street, Suite 200, San Francisco, CA 94123 2009-06-25
1407099609 Erika Cardamone Speech-Language Pathologist 2941 Gough St, 2, San Francisco, CA 94123 2009-04-17
1528216009 Melissa Jeans Maglaque Physical Therapist 2065 Vallejo St Apt 3, San Francisco, CA 94123 2008-09-09
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Taxonomy Information

Taxonomy Code 207QA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Addiction Medicine

Taxonomy Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629550660 University of California Sfgh Medical Group Family Medicine 1001 Potrero Ave Rm 5h22, San Francisco, CA 94110-3518 2018-09-06
1134341928 David Elvin Smith Family Medicine 856 Stanyan St, San Francisco, CA 94117-2752 2007-05-03
1689633638 Donald Calvin Fletcher Family Medicine 2340 Clay St # 514, San Francisco, CA 94115-1932 2006-03-20

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1194332726 True North Detox LLC Family Medicine 2413 Whitmore Ave, Clovis, CA 93619-9252 2020-09-28
1639717473 Michael Stone Md Inc Family Medicine 1950 E 17th St Ste 101, Santa Ana, CA 92705-6852 2019-12-11
1093363848 Anthony Martin Ocana Family Medicine 13924 Marquesas Way Apt 1520, Marina Del Rey, CA 90292-6018 2019-08-26
1821640137 L Snyder Incorporated Family Medicine 34052 La Plaza #101, Dana Point, CA 92629 2019-07-16
1720645328 Creative Child and Family Services, Inc. Family Medicine 7049 Ohio River Dr, Eastvale, CA 91752 2019-05-20
1932666575 Gold Country Health Initiative, LLC Family Medicine 820/830 State Highway 88, Jackson, CA 95642 2019-03-01
1952809592 Sunrise Health & Wellness Center, LLC Family Medicine 10089 Folsom Blvd. Suites A & C, Rancho Cordova, CA 95670-1935 2018-01-29
1487166120 Good Samaritan Shelter Family Medicine 412 East Tunnell Street, Santa Maria, CA 93454 2017-11-03
1790206761 Recovery Point Acute Care Family Medicine 104b W Morrison Ave, Santa Maria, CA 93458 2017-06-29
1740728831 Ginger Hulst Family Medicine 1419 Superior Ave Ste 1, Newport Beach, CA 92663-2723 2017-02-08
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Competitor

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City SAN FRANCISCO
Zip Code 94123

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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