Healthcare Provider Details

I. General information

NPI: 1447320262
Provider Name (Legal Business Name): SARA GOTTFRIED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARA SZAL MD

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 THROCKMORTON AVE
MILL VALLEY CA
94941-1909
US

IV. Provider business mailing address

436 14TH ST SUITE NUMBER 1118
OAKLAND CA
94612-2703
US

V. Phone/Fax

Practice location:
  • Phone: 415-388-5520
  • Fax: 510-388-5503
Mailing address:
  • Phone: 510-846-0973
  • Fax: 510-288-1381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA60268
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: