Healthcare Provider Details

I. General information

NPI: 1346724317
Provider Name (Legal Business Name): ERIN DONOHOE MB BCH BAO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 09/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

525 NELSON RISING LN APT 813
SAN FRANCISCO CA
94158-2302
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-8000
  • Fax:
Mailing address:
  • Phone: 415-706-8775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number158597
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: