Healthcare Provider Details

I. General information

NPI: 1669672424
Provider Name (Legal Business Name): NEERU KAUR PURI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1998 MARKET ST
SAN FRANCISCO CA
94102-6228
US

IV. Provider business mailing address

55 PACIFIC AVE
SAN FRANCISCO CA
94111-2009
US

V. Phone/Fax

Practice location:
  • Phone: 415-792-6040
  • Fax: 888-972-1912
Mailing address:
  • Phone: 415-200-2099
  • Fax: 888-972-1912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number002486
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2010-01401
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC138759
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: