Organization
WEST COAST RETINA MEDICAL GROUP, INC.
Active
Other names
West Coast Retina
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN M HIGGINBOTHAM (COO)
(415) 972-4626
Entity
Organization
Contact information
Practice address
1445 BUSH ST, SAN FRANCISCO, CA 94109-5520
(415) 972-4600
(415) 975-0999
Mailing address
1445 BUSH ST, SAN FRANCISCO, CA 94109-5520
(415) 972-4600
(415) 975-0999
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
—
—
207WX0108X
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
—
—
Other
Enumeration date
03/08/2006
Last updated
02/03/2020
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