Provider Demographics
NPI:1366534091
Name:LAPAROSCOPIC ASSOCIATES OF SAN FRANCISCO MEDICAL GROUP
Entity type:Organization
Organization Name:LAPAROSCOPIC ASSOCIATES OF SAN FRANCISCO MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSSART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-331-8390
Mailing Address - Street 1:2100 WEBSTER ST
Mailing Address - Street 2:STE 518
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2373
Mailing Address - Country:US
Mailing Address - Phone:415-331-8390
Mailing Address - Fax:415-331-8380
Practice Address - Street 1:2100 WEBSTER ST
Practice Address - Street 2:STE 518
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2373
Practice Address - Country:US
Practice Address - Phone:415-331-8390
Practice Address - Fax:415-331-8380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG750720208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty