Healthcare Provider Details

I. General information

NPI: 1427476712
Provider Name (Legal Business Name): NANCY YERKES GREENLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 4TH ST # 4034
SAN FRANCISCO CA
94143-2350
US

IV. Provider business mailing address

1825 4TH ST # 4034
SAN FRANCISCO CA
94143-2350
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7043
  • Fax:
Mailing address:
  • Phone: 415-353-7043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA141071
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberA141071
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: