Healthcare Provider Details

I. General information

NPI: 1093977621
Provider Name (Legal Business Name): MICHAEL N CORRADETTI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 SACRAMENTO ST STE 111
SAN FRANCISCO CA
94115-2383
US

IV. Provider business mailing address

405 SAINT ANDREWS DR
NAPA CA
94558-1534
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMT192993
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberC164856
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: