Healthcare Provider Details

I. General information

NPI: 1679964241
Provider Name (Legal Business Name): MARGARET ELIZABETH WHEELOCK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2015
Last Update Date: 02/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CASTRO ST STE 121
SAN FRANCISCO CA
94114-1019
US

IV. Provider business mailing address

45 CASTRO ST STE 121
SAN FRANCISCO CA
94114-1019
US

V. Phone/Fax

Practice location:
  • Phone: 415-565-6136
  • Fax:
Mailing address:
  • Phone: 415-565-6136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number134661
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: