Golden Gate Perfusion, Inc.

Primary specialty

PerfusionistTaxonomy code 242T00000X

Legal business name

GOLDEN GATE PERFUSION, INC.

Practice address

505 Parnassus Ave
San Francisco, CA 94143-2204

Phone

(451) 353-1357

NPI assigned

Mar 12, 2021

Last updated

Mar 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laurel Michelle Chambless, CCP

Title

Chief Perfusionist

Phone

(415) 341-6260

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1902481765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 ELSIE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941105149",
            "telephone_number": "415-566-6808",
            "fax_number": "415-551-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 PARNASSUS AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432204",
            "telephone_number": "451-353-1357"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 Clement St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941211563",
            "country_code": "US",
            "telephone_number": "415-221-4810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOLDEN GATE PERFUSION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "CHAMBLESS",
        "authorized_official_first_name": "LAUREL",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CHIEF PERFUSIONIST",
        "authorized_official_telephone_number": "415-341-6260",
        "authorized_official_credential": "CCP"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Perfusionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Perfusionist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Perfusionist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.