NPIMap

Organization Active NPI

North East Medical Services

  • Federally Qualified Health Center (FQHC)
  • San Francisco, CA
National Provider Identifier
1144564899
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
550002073 Issued in CA
Legal business name
NORTH EAST MEDICAL SERVICES
Practice address
1033 Clement St
San Francisco, CA 94118-2112
Phone
(415) 391-9686
Fax
(415) 433-4726
NPI assigned
Nov 19, 2012
Organization subpart
Yes
Parent organization
NORTH EAST MEDICAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eddie W. Chan, PHARM.D.
Title
President & Ceo
Phone
(415) 391-9686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 550002073 CA Primary

Addresses

Primary practice location

1033 Clement St
San Francisco, CA 94118-2112

Mailing address

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 391-9686

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidCA

Other names 1

  • North East Medical Services - Clement Other name

National Provider Directory

National Provider Directory
Tax ID family
North East Medical Services57 organizations share this tax ID, including this one
Part of
North East Medical Services

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1144564899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 STOCKTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333354",
            "telephone_number": "415-391-9686",
            "fax_number": "415-433-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 CLEMENT ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941182112",
            "telephone_number": "415-391-9686",
            "fax_number": "415-433-4726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EAST MEDICAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH EAST MEDICAL SERVICES",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "415-391-9686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "550002073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North East Medical Services - Clement",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.