Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Headquarters Medical Group West PC

Organization Sports Medicine (Family Medicine) Physician · NPI 1154289833

Headquarters Medical Group West PC is a Sports Medicine (Family Medicine) Physician in San Francisco, California. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
8
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1417 15th St
San Francisco, CA 94103-3623
Phone: (415) 763-5790
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X
Sports Medicine (Family Medicine) Physician Taxonomy 207QS0010X
Pediatric Sports Medicine Physician Taxonomy 2080S0010X
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X
Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P0301X
Neurology Physician Taxonomy 2084N0400X
Brain Injury Medicine (Psychiatry & Neurology) Physician Taxonomy 2084P0301X
Physical Therapist Taxonomy 225100000X

Record details

NPI number1154289833
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lucas Johnston — Operations Administrator · (415) 763-5790
NPI enumeratedJanuary 12, 2026
Last updated in NPPESJanuary 12, 2026
Certification dateJanuary 12, 2026
Mailing address1417 15th St, San Francisco, CA 94103-3623

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