Individual
DR. JOHN B LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 DANIEL BURNHAM CT, SAN FRANCISCO, CA 94109-5455
(415) 221-7056
(415) 221-7058
Mailing address
1 DANIEL BURNHAM CT, SAN FRANCISCO, CA 94109
(415) 221-7056
(415) 221-7058
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
G40974
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G409741
—
CA
01
—
00G792860
BLUE CROSS
CA
01
—
P00080208
RR MEDICARE
CA
Enumeration date
11/30/2006
Last updated
07/18/2017
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