MEDICARE: DR. MICHELLE MARIE PEPITONE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	G65400	CA

General Provider Information

NPI Number	:	1184636508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE MARIE PEPITONE M.D.

Provider Business Mailing Address
First Line	:	119 3RD AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1418
Country	:	US
Telephone Number	:	415-309-1975
Fax Number	:	415-668-1695

Provider Business Practice Location Address
First Line	:	119 3RD AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1418
Country	:	US
Telephone Number	:	415-309-1975
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	03/06/2023

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