Headquarters Medical Group PA

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

HEADQUARTERS MEDICAL GROUP PA

Practice address

1417 15TH St
San Francisco, CA 94103-3623

Phone

(415) 763-5790

NPI assigned

Sep 17, 2025

Organization subpart

No

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

Authorized official

Name

Lucas Johnston

Title

Operations Administrator

Phone

(973) 270-3396

Specialties & licenses 8

Addresses

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

{
    "created_epoch": "1758067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1326919655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 15TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941033623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 15TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941033623",
            "telephone_number": "415-763-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEADQUARTERS MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-17",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "LUCAS",
        "authorized_official_title_or_position": "OPERATIONS ADMINISTRATOR",
        "authorized_official_telephone_number": "973-270-3396"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P0301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Brain Injury Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Brain Injury Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Family Medicine) Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Sports Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; 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.