Imboden, John Baskerville

Imboden, John Baskerville is an individual health care provider with primary practice located at 1001 Potrero Avenue Bldg 30 Rm 3300, San Francisco CA 94110-3518. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Rheumatology is his primary health care specialty. Imboden, John Baskerville can be contacted via phone (415) 206-5438.

Contact Information

Primary practice address
1001 Potrero Avenue Bldg 30 Rm 3300 San Francisco CA 94110-3518
Phone: (415) 206-5438
Fax: (415) 648-8425
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G44969 California
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X G44969 California

Profile Details

NPI number 1275689408
LBN Legal business name Imboden, John Baskerville
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2007
Last updated Jan 17th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275689408 NPPES
California MEDICAID 00G449690

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