Active NPI
Philip Resnikoff, PA
- Medical Physician Assistant
- San Francisco, CA
National Provider Identifier
1073662953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10653
- Practice address
- 2410 California St
San Francisco, CA 94115-2681 - Phone
- (415) 529-4050
- Fax
- (415) 291-0489
- NPI assigned
- Jan 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10653 | CA | Primary |
Addresses
Primary practice location
2410 California St
San Francisco, CA 94115-2681
Mailing address
2410 California St
San Francisco, CA 94115-2681
Phone (415) 529-4050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10653 | CA | MD | Optometrist |
| PA10653 | CA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412121600000",
"number": "1073662953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2410 CALIFORNIA ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941152681",
"telephone_number": "415-529-4050",
"fax_number": "415-291-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2410 CALIFORNIA ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941152681",
"telephone_number": "415-529-4050",
"fax_number": "415-291-0489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESNIKOFF",
"first_name": "PHILIP",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-09",
"last_updated": "2014-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA10653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.