Healthcare Provider Details

I. General information

NPI: 1629797014
Provider Name (Legal Business Name): ARCELIE MARASIGAN BAIRAN LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MARKET ST FL 1
SAN FRANCISCO CA
94103-1509
US

IV. Provider business mailing address

852 87TH ST
DALY CITY CA
94015-3607
US

V. Phone/Fax

Practice location:
  • Phone: 415-863-3883
  • Fax: 415-863-7343
Mailing address:
  • Phone: 415-863-3883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number195299
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: