Healthcare Provider Details

I. General information

NPI: 1336387299
Provider Name (Legal Business Name): GERALDINA TERESA LIONETTI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 PARNASSUS AVE ROOM U127, BOX 0133
SAN FRANCISCO CA
94143-2208
US

IV. Provider business mailing address

533 PARNASSUS AVE ROOM U127, BOX 0133
SAN FRANCISCO CA
94143-2208
US

V. Phone/Fax

Practice location:
  • Phone: 415-514-3207
  • Fax: 415-476-3466
Mailing address:
  • Phone: 415-514-3207
  • Fax: 415-476-3466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA103471
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License NumberA103471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: