Jacob O Wardwell
Family Doctor - Sports Medicine
450 Sutter St Rm 1341
San Francisco
, California 94108-4007
Jacob O Wardwell
Family Doctor - Sports Medicine
450 Sutter St Rm 1341
San Francisco
, California 94108-4007
(415) 862-0626
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Jacob O Wardwell
- 450 Sutter St Rm 1341
- San Francisco, CA
- Zip : 94108-4007
- Fax : (415) 862-0626
- Phone : (415) 606-0309
Second Address
- Jacob O Wardwell
- 450 Sutter St Rm 1341
- San Francisco, CA
- Zip : 94108-4007
- Fax : (415) 862-0626
- Phone : (415) 606-0309
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | 12776 | CA |
National Provider Identifier
| NPI | 1063723781 |
|---|---|
| Provider Name | Jacob O Wardwell |
| First Address | San Francisco, CA 94108-4007 |
| Second Address | San Francisco, CA 94108-4007 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/06/2010 |
| Last Update Date | 21/02/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.