Healthcare Provider Details

I. General information

NPI: 1699880856
Provider Name (Legal Business Name): RENATA C. GALLAGHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 4TH ST
SAN FRANCISCO CA
94143-2350
US

IV. Provider business mailing address

550 16TH STREET, BOX 0706 FOURTH FLOOR
SAN FRANCISCO CA
94143
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-9184
  • Fax:
Mailing address:
  • Phone: 415-476-9997
  • Fax: 415-476-9976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0202X
TaxonomyClinical Biochemical Genetics Physician
License NumberA77290
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA77290
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberA77290
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: