Healthcare Provider Details

I. General information

NPI: 1386175867
Provider Name (Legal Business Name): POOJA PRASAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2017
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE FL 5
SAN FRANCISCO CA
94143-2202
US

IV. Provider business mailing address

505 PARNASSUS AVE RM M1182
SAN FRANCISCO CA
94143-2204
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2873
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License NumberA157711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: