Healthcare Provider Details

I. General information

NPI: 1295391449
Provider Name (Legal Business Name): EDINA AMALIA WAPPLER-GUZZETTA MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EDINA AMALIA WAPPLER MD, PHD

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 POTRERO AVE BLDG 5
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

960 MASSACHUSETTS AVENUE FL 2
BOSTON MA
02118-2690
US

V. Phone/Fax

Practice location:
  • Phone: 628-206-3496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number1022433
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number1022433
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License NumberA182451
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: