MEDICARE: MRS. MARIA S TUTHILL

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1891980264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA S TUTHILL

Provider Business Mailing Address
First Line	:	525 BELLEVUE AVE
Second Line	:
City	:	DALY CITY
State	:	CA
Zip	:	94014-1226
Country	:	US
Telephone Number	:	415-581-2438
Fax Number	:	415-581-2498

Provider Business Practice Location Address
First Line	:	30 VAN NESS AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-6020
Country	:	US
Telephone Number	:	415-206-6550
Fax Number	:	415-206-6552

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

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	09/10/2007

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