Healthcare Provider Details

I. General information

NPI: 1023207511
Provider Name (Legal Business Name): ZSOFIA BANHEGYI LONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST
SAN FRANCISCO CA
94143-2351
US

IV. Provider business mailing address

1975 4TH ST
SAN FRANCISCO CA
94143-2351
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-5153
  • Fax:
Mailing address:
  • Phone: 415-476-5153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberA97292
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberA97292
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA97292
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: