Healthcare Provider Details

I. General information

NPI: 1366714925
Provider Name (Legal Business Name): CATHERINE ALICIA SANDERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2012
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 BRYANT ST
SAN FRANCISCO CA
94103-4514
US

IV. Provider business mailing address

915 BRYANT ST
SAN FRANCISCO CA
94103-4514
US

V. Phone/Fax

Practice location:
  • Phone: 415-777-9953
  • Fax: 415-777-4717
Mailing address:
  • Phone: 415-777-9953
  • Fax: 415-777-4717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA43485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: