Healthcare Provider Details

I. General information

NPI: 1649483991
Provider Name (Legal Business Name): REGINA LISA ARVON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 01/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 CALIFORNIA ST SUITE # 1320
SAN FRANCISCO CA
94118-1618
US

IV. Provider business mailing address

229 S FAIRMOUNT ST 3RD FLOOR
PITTSBURGH PA
15206-3541
US

V. Phone/Fax

Practice location:
  • Phone: 215-868-1603
  • Fax:
Mailing address:
  • Phone: 215-868-1603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberMD 418884
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberA100240
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberA100240
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: