Organization
BAY AREA REHABILITATION MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH FECHTNER M.D. (PARTNER)
(415) 750-5761
Entity
Organization
Contact information
Practice address
2250 HAYES ST, SAN FRANCISCO, CA 94117-1013
(415) 750-5761
(415) 666-0210
Mailing address
2250 HAYES ST, SAN FRANCISCO, CA 94117-1013
(415) 750-5761
(415) 666-0210
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
G817050
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP1128
GROUP MCRERR
CA
05
—
GR0008970
—
CA
05
—
GR0008971
—
CA
05
—
GR0008972
—
CA
05
—
GR0008973
—
CA
01
—
ZZZ00551Z
GROUP LEGACY
CA
01
—
ZZZ00899Z
GROUP LEGACY
CA
01
—
ZZZ14205Z
GROUP LEGACY
CA
Enumeration date
05/27/2005
Last updated
02/01/2008
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