Healthcare Provider Details

I. General information

NPI: 1720211279
Provider Name (Legal Business Name): MOLLY R HEUBLEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 10/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2356 SUTTER ST, 3RD FLOOR UCSF WOMEN'S HEALTH PRIMARY CARE
SAN FRANCISCO CA
94115
US

IV. Provider business mailing address

2356 SUTTER ST, 3RD FLOOR UCSF WOMEN'S HEALTH PRIMARY CARE
SAN FRANCISCO CA
94115
US

V. Phone/Fax

Practice location:
  • Phone: 451-885-7788
  • Fax:
Mailing address:
  • Phone: 451-885-7788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA120931
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: