Healthcare Provider Details

I. General information

NPI: 1235281908
Provider Name (Legal Business Name): ELIZABETH J. STUART MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 MARKET ST SUITE 646
SAN FRANCISCO CA
94102-3099
US

IV. Provider business mailing address

870 MARKET ST SUITE 646
SAN FRANCISCO CA
94102-3099
US

V. Phone/Fax

Practice location:
  • Phone: 415-989-9099
  • Fax: 888-747-0798
Mailing address:
  • Phone: 415-989-9099
  • Fax: 888-747-0798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA80073
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: