Organization
INSTITUTE ON AGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANA R BLADES (CFO)
(415) 750-4101
Entity
Organization
Contact information
Practice address
3575 GEARY BLVD, SAN FRANCISCO, CA 94118-3212
(415) 750-4101
Mailing address
3575 GEARY BLVD, SAN FRANCISCO, CA 94118-3212
(415) 750-4101
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114132941
—
CA
05
—
1285906164
—
CA
05
—
1497964647
—
CA
05
—
1629251772
—
CA
05
—
1730307117
—
CA
05
—
1932314622
—
CA
05
—
1942418884
—
CA
01
—
MSSP06
MSSP - LEGACY
CA
Enumeration date
08/15/2014
Last updated
06/27/2022
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