Organization
CALIFORNIA SPINE DIAGNOSTICS MEDICAL GRP INC
Active
Other names
California Spine Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LILY O'NEILL (ADMINISTRATOR)
(415) 600-7831
Entity
Organization
Contact information
Practice address
2100 WEBSTER ST, SUITE 518, SAN FRANCISCO, CA 94115
(415) 600-7830
(415) 600-7835
Mailing address
2100 WEBSTER ST, SUITE 518, SAN FRANCISCO, CA 94115
(415) 600-7830
(415) 600-7835
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
G84882
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123360800
US DEPT OF LABOR
—
01
—
P00111961
RAILROAD RETIREMENT
—
Enumeration date
08/08/2006
Last updated
01/19/2011
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