Healthcare Provider Details

I. General information

NPI: 1750313383
Provider Name (Legal Business Name): MADELINE B DEUTSCH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 03/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 STANYAN ST EMERGENCY DEPARTMENT
SAN FRANCISCO CA
94117
US

IV. Provider business mailing address

2261 MARKET ST #612
SAN FRANCISCO CA
94114
US

V. Phone/Fax

Practice location:
  • Phone: 415-373-9330
  • Fax: 323-679-0389
Mailing address:
  • Phone: 415-373-9330
  • Fax: 323-679-0389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA80419
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA80419
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: