Healthcare Provider Details

I. General information

NPI: 1336307370
Provider Name (Legal Business Name): SERGIO FRANCO AZZOLINO NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 BROADWAY STE 1A
SAN FRANCISCO CA
94109-2539
US

IV. Provider business mailing address

1545 BROADWAY STE 1A
SAN FRANCISCO CA
94109-2539
US

V. Phone/Fax

Practice location:
  • Phone: 415-563-3800
  • Fax: 415-292-7911
Mailing address:
  • Phone: 415-563-3800
  • Fax: 415-292-7911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC23733
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95036249
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: