Marina Harbor Detox
Family Medicine (Addiction Medicine)

Address: 289 Marina Blvd, San Francisco, CA 94123-1212
Phone: 4158683858

Marina Harbor Detox (NPI# 1720624497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1720624497
Entity Type Organization
Practice Address 289 Marina Blvd
San Francisco
CA 94123-1212
Practice Telephone 4158683858
Mailing Address 289 Marina Blvd
San Francisco
CA 94123-1212
Mailing Telephone 4158683858
Authorized Official Name John E Terwelp (EXECUTIVE DIRECTOR)
Authorized Official Telephone 9255950871
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2019-11-18
Last Update Date 2019-11-18

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207QA0401X Family Medicine · Addiction Medicine Allopathic & Osteopathic Physicians

Taxonomy Information

Taxonomy Code 207QA0401X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Addiction Medicine

Taxonomy Definition

A family medicine physician who specializes in the diagnosis and treatment of addictions.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians.

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Office Location

Street Address 289 MARINA BLVD
State CA
Zip Code 94123-1212

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437611357 Sarah Wenton Alexander Occupational Therapist 3007 Fillmore Street #3, San Francisco, CA 94123 2019-04-01
1306203138 Cora Ann Keene Marriage & Family Therapist 1795 Union St, San Francisco, CA 94123 2016-01-25
1437556818 Haley Alexander Behavior Analyst 3750 Scott St Apt 205, San Francisco, CA 94123 2014-12-01
1992055040 Robert J Buonfiglio Psychologist 1738 Union Street # 302, San Francisco, CA 94123 2012-09-17
1750656732 Jane C Freston Occupational Therapist 1849 Chestnut Street, Apartment 4, San Francisco, CA 94123 2012-03-09
1700114212 Marlene Ellen Kushner Marriage & Family Therapist 2918 Webster Street, San Francisco, CA 94123 2009-11-20
1487980447 Acupuncture for Athletics Acupuncturist 1996 Union Street, 3rd Floor, San Francisco, CA 94123 2009-10-27
1104054436 Sarah Elizabeth Bothe Psychologist 1738 Union Street, Suite 200, San Francisco, CA 94123 2009-06-25
1407099609 Erika Cardamone Speech-Language Pathologist 2941 Gough St, 2, San Francisco, CA 94123 2009-04-17
1528216009 Melissa Jeans Maglaque Physical Therapist 2065 Vallejo St Apt 3, San Francisco, CA 94123 2008-09-09
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Zip Code 94123

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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