Healthcare Provider Details

I. General information

NPI: 1457855447
Provider Name (Legal Business Name): YOLANDA TINAJERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2018
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

550 16TH STREET, 7TH FLOOR OBGYN, MAILSTOP 0132
SAN FRANCISCO CA
94143-0132
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA166414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: