Healthcare Provider Details

I. General information

NPI: 1043393663
Provider Name (Legal Business Name): JAMIE MARIE BIGELOW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 HYDE ST
SAN FRANCISCO CA
94109-5996
US

IV. Provider business mailing address

PO BOX 1023
NOVATO CA
94948-1023
US

V. Phone/Fax

Practice location:
  • Phone: 415-673-7515
  • Fax: 415-563-6259
Mailing address:
  • Phone: 415-234-6100
  • Fax: 415-234-6500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG076533
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberG076533
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG07655
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberG76533
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: