Healthcare Provider Details

I. General information

NPI: 1336601871
Provider Name (Legal Business Name): MAX ALLAN MCCLURE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2019
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

995 POTRERO AVENUE BLDG. 80, WARD 86, FL. 6
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

513 PARNASSUS AVE # S380
SAN FRANCISCO CA
94143-2205
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-2400
  • Fax:
Mailing address:
  • Phone: 415-476-9363
  • Fax: 415-476-9364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberA178642
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: