Individual
JACK WELDON MCANINCH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 POTRERO AVENUE, RM 3A20, SAN FRANCISCO, CA 94110-3518
(415) 206-8806
(415) 206-5153
Mailing address
PO BOX 7464, SAN FRANCISCO, CA 94120-7464
(415) 206-3103
(415) 206-3872
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G14761
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G147610
—
CA
Enumeration date
05/20/2006
Last updated
07/08/2007
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