Provider Demographics
NPI:1427726215
Name:FIRST OPINION HEALTH SERVICES NJ LLC
Entity type:Organization
Organization Name:FIRST OPINION HEALTH SERVICES NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MINK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-635-8281
Mailing Address - Street 1:2443 FILLMORE ST # 38015799
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1814
Mailing Address - Country:US
Mailing Address - Phone:805-635-8281
Mailing Address - Fax:
Practice Address - Street 1:630 LOS TRANCOS RD
Practice Address - Street 2:
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-8028
Practice Address - Country:US
Practice Address - Phone:805-635-8281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-06
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty