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Organization
POLARIS NEUROSCIENCE INSTITUTE LLC
Active
Organization
POLARIS NEUROSCIENCE INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO G MIRANDA M.D. (MEDICAL DIRECTOR)
(415) 561-6755
Entity
Organization
Contact information
Practice address
1199 BUSH ST STE 350, SAN FRANCISCO, CA 94109-5973
(415) 561-6755
Mailing address
1199 BUSH ST STE 350, SAN FRANCISCO, CA 94109-5973
(415) 561-6755
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A30680
CA
Other
Enumeration date
10/07/2009
Last updated
10/07/2009
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