Healthcare Provider Details

I. General information

NPI: 1841753761
Provider Name (Legal Business Name): MARCELA TORO BEJARANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 BROADWAY
OAKLAND CA
94611-5730
US

IV. Provider business mailing address

1155 4TH ST APT 520
SAN FRANCISCO CA
94158-2347
US

V. Phone/Fax

Practice location:
  • Phone: 510-752-1080
  • Fax:
Mailing address:
  • Phone: 786-351-8205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberA192997
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: