Healthcare Provider Details

I. General information

NPI: 1144461237
Provider Name (Legal Business Name): ELLIE YELDING-SLOAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 11/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 HYDE ST STE 317
SAN FRANCISCO CA
94109-4841
US

IV. Provider business mailing address

PO BOX 1023
NOVATO CA
94948-1023
US

V. Phone/Fax

Practice location:
  • Phone: 415-440-4800
  • Fax: 415-885-2183
Mailing address:
  • Phone: 415-234-6100
  • Fax: 415-234-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA106435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: