Organization
CALIFORNIA SPINE DIAGNOSTICS MEDICAL GRP INC
Active
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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