Healthcare Provider Details

I. General information

NPI: 1851410534
Provider Name (Legal Business Name): ELDON DEAN SCHRIOCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRANCISCO ST #500
SAN FRANCISCO CA
94133-2122
US

IV. Provider business mailing address

55 FRANCISCO ST #500
SAN FRANCISCO CA
94133-2122
US

V. Phone/Fax

Practice location:
  • Phone: 415-834-3000
  • Fax: 415-834-3099
Mailing address:
  • Phone: 415-834-3000
  • Fax: 415-834-3099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberG45004
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: