Wavecrest Medicine, Inc.

LBN: Wavecrest Medicine, Inc.
Wavecrest Medicine, Inc. is an health care organization with primary practice located at 1850 Sullivan Ave Suite 320, Daly City CA 94015-2221. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Wavecrest Medicine, Inc. can be contacted via phone (650) 985-0530, or through Kealey, Kris C via phone (650) 985-0530.

Contact Information

Primary practice address
1850 Sullivan Ave Suite 320 Daly City CA 94015-2221
Phone: (650) 985-0530
Fax: (650) 985-0535
Website:
Map and Directions
Authorized official contact:
Name: Kealey, Kris C Doctor of Medicine (MD)
Phone: (650) 985-0530

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1619087988
LBN Legal business name Wavecrest Medicine, Inc.
DBA Doing business as
Authorized official Kealey, Kris C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 30th, 2006
Last updated Oct 3rd, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619087988 NPPES
California MEDICAID GR0101480

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