Healthcare Provider Details

I. General information

NPI: 1598069874
Provider Name (Legal Business Name): MICHAEL NEIL DUBROFF D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2010
Last Update Date: 12/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MAIN ST UNIT 8-C
SAN FRANCISCO CA
94105-5032
US

IV. Provider business mailing address

301 MAIN ST UNIT 8-C
SAN FRANCISCO CA
94105-5032
US

V. Phone/Fax

Practice location:
  • Phone: 415-525-4369
  • Fax:
Mailing address:
  • Phone: 415-525-4369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS003335L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: