Healthcare Provider Details

I. General information

NPI: 1366977100
Provider Name (Legal Business Name): ADRIAN WHELAN MB BCH BAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PARNASSUS AVE, SUITE A701
SAN FRANCISCO CA
94143-2208
US

IV. Provider business mailing address

533 PARNASSUS AVENUE U404, BOX 0532
SAN FRANCISCO CA
94143-0532
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-1551
  • Fax: 415-353-8381
Mailing address:
  • Phone: 415-476-1812
  • Fax: 415-476-3381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA163343
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number357062
License Number StateZZ
# 3
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberPTAL
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: