Healthcare Provider Details

I. General information

NPI: 1497910335
Provider Name (Legal Business Name): KATHERINE VANLOON MD MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 02/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 DIVISADERO ST 4TH FLOOR
SAN FRANCISCO CA
94115-3010
US

IV. Provider business mailing address

1600 DIVISADERO ST BOX 1770
SAN FRANCISCO CA
94115-3010
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-9888
  • Fax: 415-353-7023
Mailing address:
  • Phone: 415-885-3847
  • Fax: 415-353-7023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberA108398
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: