Healthcare Provider Details

I. General information

NPI: 1386987493
Provider Name (Legal Business Name): SARAH ISQUICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 12/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE # 6D SFGH OBGYN
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE # 6D SFGH OBGYN
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-4069
  • Fax:
Mailing address:
  • Phone: 415-206-4069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number133383
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: